This year due to the Covid-19 , ESICM has decided to transition the congress to an online event stimulating face-to-face meeting. The congress dates willbe 06-09 December 2020.
Visit the Fresenius Kabi virtual booth and learn more about providing Healthcare Professionals with Integrated and Innovative Solutions.
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The monitor and IoC parameters indicated in this article are fully based on Quantium’s qCON and qNOX imbedded OEM technology, ideal for Laparoscopic and any other surgery requiring a patient to be fully aenesthetized.
In this article by Jie Zhao, Zhenming Kang, Wenqin Xie, Huimei Lin, and Yang Liu published in Molecular Therapy, 18 September 2020 you can read more about Index of consciousness IoC1 (qCon) and IoC2 (qNox) and Effects of depth of Anesthesia.
Laparoscopic radical resection has been widely used for the treatment of colorectal cancer since the 1980s. Adjusting the precise anesthetic dosage has been confirmed to enhance patient recovery and also mitigate complications related to anaesthesia.
Check out if you want to read the complete article.
Every now and then there are men and women who discover or achieve something extraordinary that ultimately helps mankind in one way or another.
“A small step for men, a great step for mankind”, famous words from the astronaut Neil Armstrong when he placed the first footstep on the moon surface on July 20th 1969.
Something similar must have gone through the head of William T. G. Morton (1819-1868) when he made history while preforming the first public and successful demonstration of anaesthesia for surgical purposes. Imagining the surgical procedures that were performed before the 19th century will probably shock more than one, as many deaths occurred during surgery before anaesthesia was discovered.
This discovery helped medicine make a huge leap forward by finally providing the means to eliminate (or at least reduce drastically) the suffering associated with surgical interventions.
Today, 174 years later we are celebrating the first public and successful demonstration of anaesthesia for surgical purposes. William Morton is certainly one of those forgotten heroes of history, to whom Quantium Medical would like to pay homage on this special day.
He would probably boast a great smile if he knew how many millions of surgeries are safely taking place everyday thanks to his efforts and the hard work of the Anaesthesiologists who master this discipline.
The solutions provided by Quantium Medical are widely used either as OEM for integration by monitor manufacturers, or as finished products created by the company.
With install bases in Europe, Asia, Latin America, and Middle East, we are proud of our global footprint.
Nonetheless, it’s not just about offering a proven solution! We live in an evolving world and technology needs to keep improving thanks to customer feedback, constant research, and a solid R&D team.
The success of our qCON / qNOX and Conox solutions is based on constant research through collaboration projects with different hospitals in Europe, US and Asia.
We are constantly reviewing our specs and looking to improve not only how our technology works, but also looking into how we can add more value to patient monitoring.
Recently one of our lead R&D persons (Carmen González Pijuan, PhD in Biomedical Engineering) concluded successfully a 3-year research project, allowing us to take our monitoring solutions to a next level.
Following is a summary of this research, for which Quantium medical has already filed a patent application: PCT/EP2018/064061.
Depth of anaesthesia monitoring integrating cerebral blood flow estimations
Cerebral blood flow (CBF) reflects the rate of delivery of arterial blood to the brain. Since no nutrients, oxygen or water can be stored in the cranial cavity due to space and pressure restrictions, a continuous perfusion of the brain is critical for survival. Anaesthetic procedures are known to affect cerebral haemodynamics, but CBF is only monitored in critical patients due, among others, to the lack of continuous and easy to use bedside monitors for this purpose.
Our research proposes a potential solution through bioelectrical impedance technology, also known as rheoencephalography (REG). The underlying hypothesis is that REG signals carry information on CBF that might be recovered by means of the application of advanced signal processing techniques, allowing us to track CBF alterations during anaesthetic procedures.
The strength of Quantium Medical is its capacity to provide new indices by applying advanced mathematical models. Throughout this research a series of analysis techniques and monitoring solutions have been used to create a solid baseline analysis that has provided valuable conclusions.
The relationship between global haemodynamics, cerebral haemodynamics and EEG based parameters are analysed, looking for causal relationships among them. Interactions were detected during anaesthetic drug infusion and patient positioning, providing evidence of the coupling between haemodynamics and brain activity.
As mentioned, causal interactions between general haemodynamics, cerebral haemodynamics and brain activity have been studied. A first analysis along complete surgical procedures has been performed, followed by a breakdown of specific events such as patient positioning or drug infusion. Brain activity, represented by EEG related variables, showed a causal relationship with haemodynamics, suggesting that clinical decisions related to anaesthesia should integrate CBF measurements to preserve hemodynamic stability at a general and cerebral level.
During propofol general anaesthesia, both CBF and EEG signals suffer changes due to the induced loss of consciousness and depressed hemodynamic activity. Our research was aimed at analysing the causal relationships between both physiological signals during anaesthetic procedures.
Besides the direct effects of propofol concentration changes in all the physiological variables under study, the causal relationships among haemodynamics and EEG might also be affected by the administration of the hypnotic drug. Even though the detected interactions are similar to those during steady state anaesthesia, several differences can be appreciated. For instance, the occurrence of causal interactions from HR and MAP towards CBF PP, CBF lin and EEG are higher, suggesting that changes in HR caused by propofol are projected in CBF and EEG. Additionally, causal effects from CBF linked to HR and EEG are also more frequent under propofol infusion, while the interactions between MAP and HR have a lower occurrence. Overall, changing the propofol effect site concentration elicits a higher number of interactions from both cerebral and global haemodynamics towards EEG.
The causal relationships between REG signals and other physiological data were assessed to explore the adequacy and need for REG monitoring during surgery. Overall, considering all the surgical procedures, interactions between general haemodynamics, brain haemodynamics and electroencephalographic activity (EEG) were detected, confirming the hypothesis that CBF is linked to both the hemodynamic stability and the brain activity modulated by anaesthetic drugs. Additionally, specific events during the anaesthetic procedures were analysed as well, such as drug infusion, patient positioning and the administration of vasoactive drugs. In all those cases, causal interactions were detected, showing that decisions on drug dosages and patient positioning should be made considering both the hemodynamic stability and depth of anaesthesia simultaneously, since hemodynamic changes might induce brain activity levels to increase or decrease, and vice versa.
From a scientific perspective, the results of this research project justify a new opportunity for REG signals, since the application of advanced signal processing techniques has shown to be effective in tracking CBF information embedded in REG recordings. Moreover, the interaction among different physiological networks has been further assessed and quantified, contributing to the knowledge on the effects of anaesthetics in the brain and the mechanisms cooperating to achieve a successful and stable anaesthetic state. Considering the clinical benefits, CBF monitoring through REG could be extended to all kind of patients, even to those initially at low risk, making it possible to reduce the occurrence of adverse events that might sometimes have deleterious effects for patients.
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Customer feedback is highly important for us, as this is key for our efforts in continuous improvement of our monitoring technology.
Wellcare Medical Apparatus Co. Ltd. is one of our long lasting customers overseas, and we would like to share in this section how the company is supporting the different hospitals that they serve with Quantium Medical monitoring technology.
Wellcare was established in 2008 by its founder Mr. Bian Handao, leveraging over 25 years of experience in anaesthesia clinical practice in combination with Quantum’s monitoring solutions to improve patient care during surgery.
Mr. Bian engaged in the business of medical equipment in May 1995, focusing on anaesthesia monitoring. Wellcare Medical is today one of the reference companies in China, helping hospitals gain better results in their surgical procedures with the use of Quantium Medical anaesthesia monitoring technology.
Established in Shenzhen and specialized in multi parameter depth of anaesthesia monitoring, the company manages it’s business operations from product development to manufacturing and supply chain to hospitals.
What really makes Wellcare outstanding though is the accumulated clinical practice knowledge in anaesthesia monitoring that Mr. Bian transforms into coaching of hospital staff and specialists on best practices to get optimal results during surgery for patients. This translates into minimizing risk, minimizing overdosing of anaesthesia, and improving patient recovery times (more patients can be handled with better results).
Wellcare has positioned Quantium Medical monitoring technology in many large and mid-sized hospitals throughout China, where now the qCON and qNOX parameters are considered as best performing monitoring parameters in the market.
Quantium Medical is excited about the widespread use of its technology in Chinese hospitals such as: Beijing Xuanwu Hospital, Beijing Chaoyang Hospital, Beijing Union Medical College Hospital, Beijing 301 Hospital, Shanghai Ruijin Hospital, Shanghai Luwan Hospital, Shanghai Huashan Hospital, China Medical University Affiliated Hospital, Zhengda First Affiliated Hospital, etc.
Our monitoring solution is constantly being tested and improved during all kinds of surgery such as: Laparoscopic surgery, orthopedic surgery, surgery for elderly patients, surgery for children, especially adult surgery, to avoid carbon dioxide poisoning, to ensure the stability of the physiological parameters predict the operation and to avoid and prevent hypoxia in the operation patients.
This achievement makes us really proud and tells us that our technology is on the right path.
In January 2020, the outbreak of the coronavirus (Covid-19) was declared a public health emergency by the World Health Organization.
The infection rate has proven to be dramatically high due to its volatility, quickly reaching a pandemic stage, affecting billions of people and global economy. Health systems in all affected countries have been caught off-guard, saturating beds and Intensive Care Units (ICU).
Many hospitals and pharma companies are currently carrying out multiple studies aimed at helping to understand and fight the disease on one hand, while looking also at how to improve patient care in the hospitals. Although many of the studies are quite recent and are still adding clinical subjects to confirm initial findings, some interesting findings are being observed re. the use of EEG-based anaesthesia monitors.
Studies have been carried out In the Chinese Jinyintan Hospital in Wuhan, where it has been observed that a majority (67-85%) of critically ill patients admitted in ICU with confirmed infection of severe acute respiratory syndrome (SARS-Covid-2) have developed the acute respiratory distress syndrome (ARDS) [1,2]. The growing volume of ICU patients requiring long term continuous monitoring due to the development of these severe conditions on Covid-19 infected patients could in our opinion become a continuous trend as long as there is no definitive cure.
Recently, another study has been carried out using a new mechanical respiration index to directly quantify the potential for lung recruitment, as the characteristics for patients with ARDS remain unknown. This is the first study that describes mechanical respiration-based lung recruitment and also evaluates the effect of body position [3].
The study was carried out on mechanically ventilated patients with ARDS associated with SARS-CoV2 and, although the sample is limited, a series of interesting results have been obtained. Among them, it can be highlighted that an alternate body position (i.e. prone) increases the lung recruitment capability.
Furthermore, according to observations made by ICU specialists and Anaesthesiologists in hospitals, it has been observed that the use of qCON sensors is giving better results than some other sensors on the market during the prone position, in which the patient lies flat with the chest down. The key to the better results are based on the design of the qCON single strip sensor that is totally flat and manufactured with fully flexible soft material and being totally non-invasive. Even when the head weight of the patient is fully placed on the sensor, the effect of injuries to the forehead skin is mitigated. This makes the qCON monitor and sensor an ideal solution for any type of surgery or ICU patient requiring to be in the Prone position.
This advantage, detected with Covid-19 patients has also already been highlighted by many hospitals during their general use, being also extensible to any situation of critical patients being admitted in intensive care units for long duration such as trauma or other complex ICU -stay, e.g. related to cardiac-, pulmonary-, transplant-operations, etc.
With a simple use of the qCON OEM technology and its sensors, the comfort of the patient is increased, while minimizing injuries that can be derived from the prolonged use of sensors.
ARDS cases require deep sedation in early stages until the patient’s respiratory situation improves. A deep level of sedation must be carefully controlled and should not be maintained longer than necessary, in order to avoid drug accumulation and complications derived from over-sedation. In addition there are often situations where sedated patients are administered with a mix of anti-viral and other drugs. In particular the use of Anti-viral drugs may alter the effect of the provided anaesthesia for the patient, increasing the importance of constant patient state monitoring.
In a situation of critical state of the patient combined with the use of multiple drugs, the use of the qCON – EEG monitor will help to regulate better the administered drugs and maintain the patient at a correct level of sedation. Note: the QM qCON monitor provides a simple to read index, where the sedation state is defined between the values 80 to 60, while 75 is the ideal value.
As manufacturer, Quantium Medical recommends to strictly follow hygienic measures valid for Covid-19. It is crucial to clean the device and the patient cable after each use, following the manufacturer’s instructions. The sensors should be taken out of their hermetically sealed pouches immediately before their use to avoid contact with any another surface. The guidelines regarding the single use of sensors must be followed strictly in order to avoid contact with other patients, while disposing appropriately of the sensor immediately after use.
The Quantium medical proprietary technology with qCON and qNOX parameters provides a patient monitoring solution utilizing an EEG single strip-sensor. Widely used during general anaesthesia in surgery and sedation state of patients in Intensive Care Units (ICU), it allows the specialists to have real time targeted information at any given moment for the state of the patients.
References:
“EEG Symposium for Anesthesiologists” is a course that aims to offer the anesthesiologist information to know how the tracing of the electroencephalogram can be a useful tool to assess the effect of anesthetic drugs, and surgical intervention, on the central nervous system for a short and long term.
Get more information here
This event will take place in Barcelona on the 22nd of November at the Hotel ABBA Sants.
Medica is the number one medical congress in the world. It will take place from 18 to 21 November in Düsseldorf, Germany.
Quantium Medical will exhibit its cardiac output and depth of anaesthesia OEM boards, designed to be integrated into multiparametric monitors.
We’ll be sharing booth with Votem in Hall 10, C46.
Contact us to see us
Consult Medica site for more information.
We travel to Orlando to attend the ASA Annual meeting next 19-23 October.
We are expecting to meet more than 14,000 clinicians at the Orange County Convention.
Don’t miss the opportunity to come and visit us in Fresenius Kabi booth (521). We will show you our non-invasive monitoring technology!
More information
Saturday: 10:00 – 16:00
Sunday: 9:00 – 16:00
Monday: 9:00 – 13:00
https://www.asahq.org/annualmeeting
Quantium Medical will present the latest depth of anaesthesia and nociception/pain monitoring.Please join us on Friday the 18th of October in Orlando for the ISAP meeting.