A novel simulator for mechanical ventilation in newborns: MEchatronic REspiratory System SImulator for Neonatal Applications

Abstract

Respiratory problems are among the main causes of mortality for preterm newborns with pulmonary diseases; mechanical ventilation provides standard care, but long-term complications are still largely reported. In this framework, continuous medical education is mandatory to correctly manage assistance devices. However, commercially available neonatal respiratory simulators are rarely suitable for representing anatomical and physiological conditions; a step toward high-fidelity simulation, therefore, is essential for nurses and neonatologists to acquire the practice needed without any risk. An innovative multi-compartmental infant respirator simulator based on a five-lobe model was developed to reproduce different physio-pathological conditions in infants and to simulate many different kinds of clinical scenarios. The work consisted of three phases: (1) a theoretical study and modeling phase, (2) a prototyping phase, and (3) testing of the simulation software during training courses. The neonatal pulmonary simulator produced allows the replication and evaluation of different mechanical ventilation modalities in infants suffering from many different kinds of respiratory physio-pathological conditions. In particular, the system provides variable compliances for each lobe in an independent manner and different resistance levels for the airway branches; moreover, it allows the trainer to simulate both autonomous and mechanically assisted respiratory cycles in newborns. The developed and tested simulator is a significant contribution to the field of medical simulation in neonatology, as it makes it possible to choose the best ventilation strategy and to perform fully aware management of ventilation parameters.

A review of recent advancements in soft and flexible robots for medical applications

“…Soft medical robots are multidisciplinary emerging technologies such as materials science, bionics, mechanics, electronics, and computer science. At present, soft medical robots have been used for surgery, diagnosis, rehabilitation, prostheses, artificial organs, drug delivery and many other medical applications . The movements such as bending, torsion, extension, and contact operations required high flexibility and deformability of soft medical robots.…”

Projeto de um simulador respiratório para aplicações neonatais.

“…Figura 2.36 -Imagem do protótipo construído pelo trabalho. (Baldoli, et al, 2015  extremo baixo peso sem broncodisplasia pulmonar; EBP c/ BDP  extremo baixo peso com broncodisplasia pulmonar. (Stankiewicz, Palko, Darowski, Zielisnki, & Kozarski, 2017)…”

“…Parte real da impedância do sistema respiratório (Baldoli, et al, 2015) Autores sugerem que o mercado de simuladores respiratórios na neonatologia é dividido em 3 segmentos distintos: manequins de simulação, simuladores passivos e simuladores ativos. (Stankiewicz, et al, 2017) Manequins A fim de apresentar os modelos matemáticos do sistema respiratório utilizados na literatura e em alguns dos simuladores acima é necessário introduzir alguns conceitos e definições fundamentais, entre eles, o sistema respiratório e sua anatomia,…”

“…Note que é possível identificar 2 regiões distintas, uma relativa à complacência dinâmica e outra referente a resistência não linear. (Schmidt, Foitzik, Hochmuth, & Schmalisch, 2003) A planta desse simulador é constituída por um único compartimento na forma de pistão, onde a posição do pistão é controlada por alguns fatores, dentre eles um servo motor, um sistema de resistência de fluxo a ar e mais uma série de componentes eletrônicos a fim de obter os dados necessários para a implementação do sistema de (Baldoli, et al, 2015) Com isso, as seguintes equações podem ser obtidas:…”

“…(Baldoli, et al, 2015) .............................................................................................................................. 65 Figura 2.34 -GUI do simulador MERESSINA. (Baldoli, et al, 2015) (Baldoli, et al, 2015) .…”