Article
Engineering, Biomedical
Philip von Platen, Philipp A. Pickerodt, Martin Russ, Mahdi Taher, Lea Hinken, Wolfgang Braun, Rainer Koebrich, Anake Pomprapa, Roland C. E. Francis, Steffen Leonhardt, Marian Walter
Summary: This study proposes a mechanical ventilation system that combines clinical evidence and expert knowledge to achieve personalized and lung-protective ventilation. In a pilot study on animals, the system achieved a time-in-target of over 75% for all goals and prevented critical phases of low oxygen saturation.
BIOMEDICAL ENGINEERING ONLINE
(2023)
Article
Medicine, General & Internal
Hong Ren, Li Xie, Zhulin Wang, Xiaoliao Tang, Botao Ning, Teng Teng, Juan Qian, Ying Wang, Lijun Fu, Zhanqi Zhao, Long Xiang
Summary: The study aims to compare the difference in positive end-expiratory pressure (PEEP) selection between chest electrical impedance tomography (EIT) and global dynamic respiratory system compliance (C-rs) in moderate-to-severe pediatric acute respiratory distress syndrome (pARDS). The results suggest that in moderate-to-severe pARDS, PEEP selected based on C-rs might not be inferior to EIT-guided regional ventilation.
FRONTIERS IN MEDICINE
(2022)
Article
Critical Care Medicine
Colin K. Grissom, Michael J. Lanspa, Danielle Groat, Jason R. Jacobs, Lori Carpenter, Kathryn G. Kuttler, Lindsay Leither, Ithan D. Peltan, Samuel M. Brown, Rajendu Srivastava
Summary: This study implemented a computerized protocol for low tidal volume ventilation to improve the management and outcomes of mechanically ventilated patients. After the implementation, the set tidal volume decreased and more patients received the protocol. However, no improvement in clinical outcomes was observed.
CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Annemijn H. Jonkman, Glasiele C. Alcala, Bertrand Pavlovsky, Oriol Roca, Savino Spadaro, Gaetano Scaramuzzo, Lu Chen, Jose Dianti, Mayson L. de A. Sousa, Michael C. Sklar, Thomas Piraino, Huiqing Ge, Guang-Qiang Chen, Jian-Xin Zhou, Jie Li, Ewan C. Goligher, Eduardo Costa, Jordi Mancebo, Tommaso Mauri, Marcelo Amato, Laurent J. Brochard
Summary: This study used electrical impedance tomography (EIT) to quantify lung recruitability and proposed a method to select optimal positive end-expiratory pressure (PEEP) based on EIT. The researchers found that there is a wide variation in recruitability among COVID-19 patients, and EIT can help personalize PEEP setting to balance recruitability and overdistension.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Michael Cardinale, Salah Boussen, Pierre-Julien Cungi, Pierre Esnault, Quentin Mathais, Julien Bordes, Eric Meaudre, Philippe Goutorbe
Summary: This study evaluated the correlation between dependent lung area collapse and oxygenation response to prone ventilation in patients with COVID-19 acute respiratory distress syndrome. The results showed a positive correlation between dependent area collapse and oxygenation response to prone ventilation, with a high prediction accuracy.
CRITICAL CARE MEDICINE
(2022)
Review
Physiology
Mengru Xu, Huaiwu He, Yun Long
Summary: EIT technology offers promise in bedside visual assessment of lung perfusion distribution, with attention being focused on the saline bolus EIT method. Experimental and clinical studies have demonstrated good consistency between saline bolus EIT and SPECT in evaluating lung perfusion changes in various pathological conditions. Further research is needed to establish consensus on the clinical application and impact of the saline bolus EIT method.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Critical Care Medicine
Ruiting Li, Yongran Wu, Hongling Zhang, Azhen Wang, Xin Zhao, Shiying Yuan, Le Yang, Xiaojing Zou, You Shang, Zhanqi Zhao
Summary: The aim of this study was to investigate the physiological impact of airway pressure release ventilation (APRV) on patients with early moderate-to-severe acute respiratory distress syndrome (ARDS) by electrical impedance tomography (EIT). The results showed that APRV optimizes the distribution of ventilation and perfusion, reducing lung heterogeneity, which potentially reduces the risk of ventilator-induced lung injury.
Article
Critical Care Medicine
Yi Xin, Kevin Martin, Caio C. A. Morais, Paolo Delvecchio, Sarah E. Gerard, Hooman Hamedani, Jacob Herrmann, Nicholas Abate, Austin Lenart, Shiraz Humayun, Uday Sidhu, Mihail Petrov, Kristan Reutlinger, Tal Mandelbaum, Ian Duncan, Nicholas Tustison, Stephen Kadlecek, Shampa Chatterjee, James C. Gee, Rahim R. Rizi, Lorenzo Berra, Maurizio Cereda
Summary: The effects of prone positioning on lung aeration may be influenced by the stage of lung injury, with less reinflation in late-stage patients compared to early-stage patients. Additionally, prone positioning decreased aeration in the anterior lung regions. These findings suggest that the efficacy of prone positioning in improving lung aeration may be limited by the stage of lung injury.
CRITICAL CARE MEDICINE
(2021)
Review
Biology
Douglas Slobod, Anna Damia, Marco Leali, Elena Spinelli, Tommaso Mauri
Summary: In patients with acute respiratory distress syndrome (ARDS), disturbances in the physiological matching of air and blood flow (V/Q mismatch) can worsen lung injuries and lead to adverse outcomes. This review discusses various methods for measuring air and blood flow equilibration, and presents clinical and experimental evidence showing a link between V/Q mismatch and lung injury. It emphasizes the importance of individualized therapy based on a detailed understanding of each patient's pathophysiology. Innovations in bedside imaging technologies, such as electrical impedance tomography, provide new insights into the management of ARDS by determining the regional distributions of air and blood flow and their matching.
Article
Radiology, Nuclear Medicine & Medical Imaging
Lin Yang, Meng Dai, Knut Moeller, Inez Frerichs, Andy Adler, Feng Fu, Zhanqi Zhao
Summary: The study proposes a novel method to correct the calculation of ventilation heterogeneity index using anatomical information, which is found to be more accurate in assessing ventilation distribution compared to traditional methods.
QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
(2021)
Article
Pediatrics
Laura L. H. He, Gillian Foo, Kelly R. Kenna, Ellen Douglas, Monique Fatmous, Rebecca J. Sutton, Elizabeth J. Perkins, Magdy Sourial, Prue M. Pereira-Fantini, David G. Tingay, Arun Sett
Summary: This study aimed to determine whether lung ultrasound (LUS) can detect regional inhomogeneity in premature lambs identified by electrical impedance tomography (EIT). The study found that LUS can measure regional aeration, which should be further explored in human studies.
PEDIATRIC RESEARCH
(2023)
Article
Critical Care Medicine
Yu-xian Wang, Ming Zhong, Min-hui Dong, Jie-qiong Song, Yi-jun Zheng, Wei Wu, Jia-le Tao, Ling Zhu, Xin Zheng
Summary: This study investigated the effect of prone positioning on ventilation-perfusion matching in ARDS patients using contrast-enhanced electrical impedance tomography (EIT). The findings showed that prolonged prone ventilation improved dorsal ventilation and perfusion, resulting in improved ventilation-perfusion matching and oxygenation.
Article
Critical Care Medicine
Jose Dianti, Samira Fard, Jenna Wong, Timothy C. Y. Chan, Lorenzo Del Sorbo, Eddy Fan, Marcelo B. Passos Amato, John Granton, Lisa Burry, W. Darlene Reid, Binghao Zhang, Damian Ratano, Shaf Keshavjee, Arthur S. Slutsky, Laurent J. Brochard, Niall D. Ferguson, Ewan C. Goligher
Summary: This study aimed to optimize respiratory effort in patients with acute hypoxemic respiratory failure (AHRF) to achieve lung- and diaphragm-protective (LDP) targets. Titrating ventilation and sedation could optimize respiratory effort for lung and diaphragm protection in most patients, and the use of veno-venous extracorporeal membrane oxygenation (VV-ECMO) facilitated the delivery of a LDP strategy. Partial neuromuscular blockade (pNMBA) treatment was effective for patients with excessive respiratory effort.
Article
Respiratory System
Tobias H. Becher, Martijn Miedema, Merja Kallio, Thalia Papadouri, Christina Karaoli, Louiza Sophocleous, Marika Rahtu, Ruud W. van Leuteren, Andreas D. Waldmann, Claas Strodthoff, Rebecca Yerworth, Antoine Dupre, Mohamed-Rida Benissa, Sven Nordebo, Davood Khodadad, Richard Bayford, Roseanne Vliegenthart, Peter C. Rimensberger, Anton H. van Kaam, Inez Frerichs
Summary: This study evaluated the feasibility and safety of long-term monitoring using electrical impedance tomography (EIT) in neonates and young children with respiratory failure. The results showed that EIT allowed continuous monitoring of lung function for up to 72 hours with minimal adverse effects. The study also found that ventilation distribution was influenced by body position and varied depending on the postmenstrual age of the patients.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2022)
Article
Critical Care Medicine
Elena Spinelli, Michael Kircher, Birgit Stender, Irene Ottaviani, Maria C. Basile, Ines Marongiu, Giulia Colussi, Giacomo Grasselli, Antonio Pesenti, Tommaso Mauri
Summary: This study utilized EIT to evaluate unmatched ventilation and perfusion, finding that the percentage of unmatched units was significantly higher in non-survivors compared to survivors, and it was an independent predictor of mortality. Additionally, there were differences in ventilation and perfusion between different lung regions, and higher percentage of only perfused units correlated with lower dorsal ventilation and PaO2/FiO(2) ratio.
Article
Oncology
Annika Kurreck, Felix Gronau, Miguel Enrique Alberto Vilchez, Wiltrud Abels, Philipp Enghard, Andreas Brandl, Roland Francis, Bettina Foehre, Christian Lojewski, Johann Pratschke, Peter Thuss-Patience, Dominik Modest, Beate Rau, Linda Feldbruegge
Summary: This study retrospectively analyzed data from 238 patients who underwent CRS and CDDP-based HIPEC, confirming that STS can protect patients from AKI caused by this treatment. Patients who received STS treatment had a lower incidence and severity of AKI compared to those who did not.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Engineering, Biomedical
Martin Russ, Elvira Steiner, Willehad Boemke, Thilo Busch, Christoph Melzer-Gartzke, Mahdi Taher, Jenelle Badulak, Steffen Weber-Carstens, Erik R. Swenson, Roland C. E. Francis, Philipp A. Pickerodt
Summary: This study investigates the contribution of V-V extracorporeal membrane oxygenation (ECMO) to systemic oxygen delivery. It suggests that thermodilution-based measurements of cardiac output may be overestimated due to blood recirculation in ECMO.
Article
Engineering, Electrical & Electronic
Durmus Umutcan Uguz, Zehra Tugce Canbaz, Christoph Hoog Antink, Markus Lueken, Steffen Leonhardt
Summary: This article proposes a new technique called modulated ECG (mECG) for improving the measurement of capacitive electrocardiogram (cECG) by introducing high-frequency sinusoidal variations in contact pressure. The study shows that the amplitude of the ECG signal can be modulated by the multiplicative interaction between the source signal and the coupling impedance, and the resulting waveform can be merged with the envelope of a carrier wave. The feasibility of this technique is validated through numerical and physical simulations. Factors such as textile type, contact pressure, and modulation frequency influence the mECG measurements, and the mECG amplitudes are found to be significantly lower than those of cECG.
IEEE TRANSACTIONS ON INSTRUMENTATION AND MEASUREMENT
(2022)
Article
Engineering, Civil
Lennart Leicht, Marian Walter, Marcel Mathissen, Christoph Hoog Antink, Daniel Teichmann, Steffen Leonhardt
Summary: This study evaluates unobtrusive methods for measuring physiological features for driver state estimation. The results show that these methods can reliably monitor heart rate and respiration rate under laboratory and real driving conditions, but there are motion artifacts in urban driving scenarios.
IEEE TRANSACTIONS ON INTELLIGENT TRANSPORTATION SYSTEMS
(2022)
Article
Computer Science, Information Systems
Sanjay Chandrasekaran, Markus Lueken, Steffen Leonhardt, Uma Gandhi, Thea Laurentius, Cornelius Bollheimer, Chuong Ngo
Summary: This article proposes a model-based technique for determining step length using the Unscented Kalman Filter and data from a gyroscope. A novel covariance estimation algorithm is also introduced. The research paves the way for faster and better algorithms for covariance estimation.
IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS
(2022)
Article
Medicine, General & Internal
Patrick Borchers, Patrick Winnersbach, Sandra Kraemer, Christian Beckers, Eva Miriam Buhl, Steffen Leonhardt, Rolf Rossaint, Marian Walter, Thomas Breuer, Christian Bleilevens
Summary: This study found that axial-flow pumps may induce stronger hemolysis compared to centrifugal pumps, along with larger amounts of circulating extracellular vesicles and a stronger activation of platelets, potentially leading to adverse events in left ventricular assist device application.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Engineering, Mechanical
Lin Liu, Steffen Leonhardt, Lukas Bergmann, Berno J. E. Misgeld
Summary: This paper presents an integration of reducing the output impedance and the vibration at the trajectory tracking into one variable stiffness actuator (VSA) system. The VSA operates within the cascade impedance control framework with the unknown input observer (UIO) in the inner torque control loop. By utilizing gain-scheduled UIO and the low and high physical stiffness of VSA, the paper achieves low-output impedance and steady trajectory tracking.
MECHANISM AND MACHINE THEORY
(2023)
Article
Chemistry, Analytical
Simon Lyra, Arian Mustafa, Joeran Rixen, Stefan Borik, Markus Lueken, Steffen Leonhardt
Summary: This study investigates the application of a conditional generative adversarial network to augment limited neonatal image datasets by using edge detection frames from neonates to generate RGB images. The quality of the generated RGB images was evaluated using a multistage survey and the FID score. The promising results indicate the potential of conditional generative adversarial networks for training and application in neonatal care.
Review
Hematology
Dorothea Puchstein, Felix Kork, Herbert Schochl, Farahnaz Rayatdoost, Oliver Grottke
Summary: Long-term anticoagulation using vitamin K antagonists carries an increased risk of bleeding and requires careful management. This study compared 3-factor and 4-factor prothrombin complex concentrates (PCCs) for the reversal of vitamin K antagonist-associated coagulopathy. The analysis showed that 4F-PCC was more effective in achieving international normalized ratio (INR) goals compared to 3F-PCC. However, further research is needed to make a definitive recommendation.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Computer Science, Artificial Intelligence
Joeran Rixen, Steffen Leonhardt, Jochen Moll, Duy Hai Nguyen, Chuong Ngo
Summary: Electrical impedance tomography (EIT) is limited in spatial resolution due to sensitivity to noise. We investigate a technique to improve EIT reconstructions by incorporating a priori information into the D-Bar algorithm. Our paper aims to explain the behavior and implementation of the D-Bar algorithm, as well as the effect of adding prior information from a radar setup. We analyze different parameters of the reconstruction algorithm using GREIT figures of merit and find that even limited prior information can significantly improve reconstruction quality.
Article
Automation & Control Systems
Lukas Bergmann, Oliver Lueck, Daniel Voss, Philipp Buschermoehle, Lin Liu, Steffen Leonhardt, Chuong Ngo
Summary: This study presents the design of a new lower limb exoskeleton with variable stiffness actuators for compliant coupling. By using a nonlinear state estimation method, the subject's motion intention can be accurately estimated, providing more robust results.
IEEE-ASME TRANSACTIONS ON MECHATRONICS
(2023)
Article
Chemistry, Analytical
Onno Linschmann, Durmus Umutcan Uguz, Bianca Romanski, Immo Baarlink, Pujitha Gunaratne, Steffen Leonhardt, Marian Walter, Markus Lueken
Summary: With the increasing level of automation in vehicles, it is crucial to have robust driver monitoring systems to ensure driver intervention at any time. A portable cushion with multiple sensors is presented in this paper to monitor the heart and respiratory rates of a vehicle driver. The initial study with twenty participants in a driving simulator showed promising results in accurately measuring heart and respiratory rates, as well as the potential for monitoring changes in the electrocardiogram. These measurements can be used to detect drowsiness, stress, and predict cardiovascular diseases.
Article
Chemistry, Analytical
Markus Lueken, Michael Gramlich, Steffen Leonhardt, Nikolaus Marx, Matthias D. Zink
Summary: Atrial fibrillation (AF) is a common cardiac disorder that often goes undetected due to its asymptomatic and paroxysmal nature. Large-scale screenings can help identify silent AF early and prevent complications. This study presents a machine learning-based algorithm for assessing the signal quality of hand-held diagnostic ECG devices to improve accuracy in detecting AF.
Article
Medicine, General & Internal
Thomas Muders, Benjamin Hentze, Steffen Leonhardt, Christian Putensen
Summary: Monitoring regional blood flow distribution in the lungs is useful for optimizing ventilation therapy. Electrical impedance tomography (EIT) can measure regional lung perfusion using different contrast agents. The study evaluated the suitability of five clinically approved solutions as EIT contrast agents. NaCl 5.85% and sodium-bicarbonate 8.4% showed the best results, while Iomeprol and Glucose 5% also produced usable signals. Isotonic balanced crystalloid solution was not effective. Further research is needed to determine optimal doses and balance reliability with potential side effects.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Engineering, Mechanical
Chenglin Lyu, Pedro Truppel Morim, Bernhard Penzlin, Felix Roehren, Lukas Bergmann, Philip von Platen, Cornelius Bollheimer, Steffen Leonhardt, Chuong Ngo
Summary: This study proposes a hybrid exoskeleton approach combining a traditional exoskeleton and functional electrical stimulation (FES) for the rehabilitation of paralysis caused by a stroke or a spinal cord injury. The closed-loop FES control strategy is demonstrated to be feasible for training and shows improved performance compared to open-loop control, with reduced muscle fatigue and increased robustness.