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PAGE 28 Editorials from

PAGE 28 Editorials from EE Faculty (Cont.) Development of a Novel Pleural Drainage Monitoring System Prof. Mohieddine Benammar (EED-QU) & Dr. Rashid Mazhar (Hamad Hospital) A success story of collaboration between the Electrical Engineering Department at Qatar University and Hamad Medical Corporation. The start of research collaboration between Prof. Benammar (Qatar University) and Dr. Mazhar (Hamad Hospital) goes back more than seven years. It all started with discussions on how pleural drainage can be monitored electronically. Post-operative bleeding requiring re-exploration occurs in 2-6% of cardiac surgical patients [1]. It is established that these patients have significantly worse outcome with increased mortality and morbidity with prolonged ICU and hospital stay [2]. Delay in the time of re-exploration1 and the amount of bleeding [3] are the main causes for such adverse outcome in these patients. Time-delay to reexploration is “purchased” in the ICU at the expense of greater blood, blood products transfusion and inotropic support. Large studies have shown that amount of blood transfusion is an independent risk factor for mortality and morbidity in postoperative cardiac surgical patients [4].Hence there is clear evidence that a safe practice should ensure minimum blood transfusion and least possible delay in reexploration following cardiac surgery. At present post-operative monitoring of chest drainage is generally carried out by intermittent visual method with manual recording on paper. In case of excessive bleeding, the transmission of information to the whole operating team is a serial, time consuming process. This delay is plugged in by continued infusion of blood and its products. Same subjectivity prevails, at a less urgent scale, in pulmonary surgery, for recording post-operative air leak. Furthermore, paperbased recording of the data makes it difficult to store and retrieve. To overcome these problems, Prof. Benammar and Dr. Mazhar have designed a digital blood and air leak monitoring system (Fig. 1). This device can be externally attached to any existing chest drainage reservoir, without breach of sterility or coming in direct contact with the effluents. It enables setting of patient specific alarm threshold, automatic, real time measurement of rate and volume of drainage with high resolution, data processing, storage and local/remote, group transmission of drainage data, in a user friendly manner. The solution is based upon a combined method of weight and flow measurements using standard sensing techniques. By using appropriate fusion of the weight of the drainage reservoir and of the air flow out of it, it is possible to determine unambiguously and simultaneously both air and blood leak rates. At the heart of the device is a digital processor that performs all necessary calculations. Patient leakage data is transmitted wirelessly from the device to a personal computer where this data is stored and displayed graphically. The computer may be programmed to monitor the patient leakage data and alert surgical team in case of abnormal air and/or blood leakage rate patterns. Its usage would minimize the time delay in decision making, dissemination of information, team assembly and the time for reexploration. Data is also archived electronically in a database for long term keeping; this may be used for the purposes of audit, quality assurance, research and medicolegal concerns. The assembled prototype has recently been successfully tested in a clinical environment. The innovation has been awarded the HMC “Stars of Excellence” research award 2015 (Fig. 1) and has been filed as a US Patent [5] which is now published (Fig. 1). Qatar University and Hamad Medical Corporation have recently agreed to make few medicalgrade prototypes for thorough testing at Hamad Hospital; this will be funded by Hamad Medical Corporation. References [1]Karthik S, Grayson AD, McCarron EE, Pullan DM, Desmond MJ. Reexplorationfor bleeding after coronary artery bypass surgery: risk factors, outcomes, and the effect of time delay. Ann Thorac Surg. 2004 Aug;78(2):527- 34. [2]Galas FR, Almeida JP, Fukushima JT, Osawa EA, Nakamura RE, Silva CM, de Almeida EP, Auler JO Jr, Vincent JL, Hajjar LA. Blood transfusion in cardiac surgery is a risk factor for increased hospital length of stay in adult patients.JCardiothorac Surg. 2013 Mar 26;8(1):54. [3]Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Re-exploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J ThoracCardiovasc Surg. 1996;111:1037–1046. [4]R. Mikkola, J. Heikkinen, J. Lahtinen, R. Paone, T. Juvonen, F. Biancari. Does Blood Transfusion Affect Intermediate Survival after Coronary Artery Bypass Surgery? Scandinavian Journal of Surgery June 2013 vol. 102 no. 2 110-116. [5]M. Benammar M, Mazhar R. System, apparatus, method, and computer readable medium for monitoring volume and rate of air drained from a body. US Patent , US 2016/0271304 A1; published 22 Sept. 2016. EED NEWSLETTER VOL. 2, ISSUE 1


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