Center for Integrative Research in Critical Care by Kevin Ward
-
Upload
university-of-michigan-department-of-emergency-medicine -
Category
Health & Medicine
-
view
128 -
download
0
Transcript of Center for Integrative Research in Critical Care by Kevin Ward
Big Bold Solutions• Integrate Non-Traditional Partners
– Engineering, Data Science, Population Health, Local and Regional Entrepreneurs
• Leverage Big Data– Data in Motion for Cognitive Computing, Quantified Self, Integration of
Digital Assets for transitions of care
• Develop Strategic Partnerships– Industry as “one stop shopping” and co-product development, Department
of Defense, Other leading AMCs, Nontraditional Health Care partners
• Reduce Energy Barrier to Transformative Team Science– Proposal Develop Unit for multi-investigator grants, Ideation Sessions,
Grand Challenges, Technology Development, etc.
The Critical Care ChallengeSituational Awareness in the ICU
Processing Big Data: Volume + Variety + Velocity + VeracityClinicians may be confronted with 200 time-related variables, but can only
determine the relationship between two variables unassisted.
Novel Complexity Measures from Heart Rate Variability (HRV)
Novel Morphology Based ECGContour Analytics
Continuous Monitoring and Assessment of Hemodynamic Conditions
Using Computer-Aided Analysis of Physiological Signals
Analytic for Hemodynamic InstabilityAHI
MCIRCC Sepsis Grand Challenge
• 2014: Two day event• 70 clinicians, engineers, data
scientists, basic scientist• Educating each other on what
sepsis is, technology gaps,UM lab and engineering assets
• 300K to fund medicine-engineering partnerships to develop transformative technologies
• 14 proposals submitted and six eventually funded
• Commercialization coaching and product management guidance provided
A
BInspirationExpiration
InspirationExpiration
A
B
Figure 2: Changes in IVC diameter during A. Before hemodialysis B. At the end of hemodialysis. And corresponding bioimpedance changes. A. Before and B. After hemodialysis
Wearable Volume Monitoring:1) Real-time continuous monitoring of
IVC Diameter for Volume monitoring2) Real time Respiratory rate and
quality monitoring3) Real-time CVP monitoring4) Temperature, Heart Rate, Sleep,
and more
15Team # | Project Name
Technology:• Piezoelectric
polymer (PVDF) sensing band.
• Waveform feature extraction and analysis
• Reflects real time changes in vascular tone-compensation
• Predicts hypotension
Dynamic Arterial Morphology AssessmentNormal
IDH-Risk
Decay of reflection
waves.
FeatureExtraction
e-e-
NP AuPlanar
Au
= Redox Species
= Albumin
Pin hole
World’s First Whole Blood Oxidant Stress Monitor
Ocular Cerebral Autoregulation Monitor
Cross section and impedance pathway
• Animal intubated and mechanically ventilated• Three Burr holes for ICP measurement, LDF and subdural hematoma induction• Electrodes over eye for ocular impedance measurement• Carotid artery cannulated for blood pressure measurement
Chemical Oxygen Generation
• Oxygen tanks cannot go or be placed at many locations
• Hypoxia is a huge killer in cardiovascular and trauma conditions
• Maternal and neonatal hypoxia are major causes of death during and after child birth
• Produces 6 l/min for 20 minutes. No heat or explosive hazards
• Funded by ONR
High Fidelity Systolic Blood Pressure Monitoring
• Use SpO2 or PZT waveform to determine SBP during cuff inflation.
• Set minimum cuff inflation (90-100 mmHg).
• Loss of waveform = SBP less than set point
• Algorithm continues to find true SBP and then set at minimum target.
• Could be connected to infusion devices (Smart autonomous resuscitation)
ICU Bed of the Future
• Therapeutic Platform– Vibration, Temperature
• Diagnostic Platform– Physiologic signal capture
• Rehabilitation Platform– Physical Therapy in the ICU
• ICU to Home
24
Inflatable balloon
Pilot Balloon
Hollow member or clip to go over ET Tube
Hollow Member to ventilate through and pass additionalendotracheal tube through, stylet or fiberopitc.
MCIRCC Rescue Airway Device
Biphasic Cuirass Ventilation
• Sepsis and ARDS• Cardiogenic Shock• Multisystem Trauma• Traumatic Brain Injury• Enhanced Weaning• Asthma/COPD with or
without BiPAP
• Enhance cardiac output, decrease ICP, enhance venous return, decrease PPV complications
Scaling MCIRCC Impact
MCIRCC Core Assets- Scaling for bigger Impact:• Big Data Analytic Platform and Data Mart: Analytics research + Cognitive
computing + Clinical expertise = transformative leadership position in critical care- improved patient outcomes at reduced cost
• Large Animal ICU and OR: Complex animal models of sepsis, trauma, TBI, Cardiac Arrest
• Proposal Development Unit and Virtual Institute: Rapid Alert+ Integrative Team Mobilization + Project Management = more large grant awards
• Catalyst Core: Strategic Partnerships (industry, DOD)+ Entreprenurial Donors = New funding streams and business models
• MCIRCC Innovation Portfolio: Research funding plans ( FFMI MTRAC, COE Coulter, donors) + Grand Challenges Platform= more licenses and royalty streams
2014/15 Output SummaryMember Engagement
• 140 members from 6 U-M Schools and Colleges; actively onboarding new members. 20% COE, 70% UMMS
• Regular communications and networking activities to support membership and accelerate multidisciplinary team research.– MCIRCC Innovation Underground: Bourbon, Beer and Ideas =
Opportunity
• MCIRCC Virtual Institute (member intranet).– Most sophisticated array of funding curation and grant development
services within the UM.
• Cultivating “foundational” research communities: sepsis, traumatic brain injury (TBI), hemodynamic surveillance monitoring, cardiac arrest, combat casualty care, transfusion medicine, critical care informatics and clinical decision making
2014/15 Output SummaryIntellectual Property
• Over 40 patents and invention disclosures actively managed in the MCIRCC portfolio.
• Almost all involve Medical School and Engineering faculty.
• Largest number of Medical School Innovation grants awarded
• In licensing discussions with industry over 10 technologies.– Large, Medium and Small companies: Valued in the 100K’s to the
Billions
– 2 new spin-off with 2 more in the works.