5、麻醉模拟软件推荐:BIS Titration SimulatOR Experience
一个非常专业的BIS监测体验模拟器,适合初学的麻醉医生熟悉理解该监测仪器。
About The BIS Titration SimulatOR Experience:
The BIS Titration SimulatOR was developed as a creative learning exercise for anesthesia professionals to explore BIS-guided anesthesia titration during an animated simulation of surgery procedure. The simulator assumes that the user has basic knowledge regarding BIS monitoring.
For each patient, the user has the option of conducting the simulated anesthetic using either a volatile gas, TIVA, or TIVA-TCI technique. Regardless of technique, for a given scenario the user manages induction, intubation, ventilation, and fluids in addition to drug selection and titration. In conditions of inadequate anesthesia, analgesia, or muscle relaxant effect, surgical stimulation and pain thresholds determine patient somatic response and/or surgeon comments.
The data presented in the patient scenarios were derived from computer model simulations that were guided by published literature. For each scenario option, patient simulation software (“Body Simulation for Anesthesia” (BODY)) was used to create data for displaying numeric values and trends on the OR monitors (i.e., cardiovascular and other physiological parameters.) In addition, BODY calculated predicted volatile agent concentrations and predicted blood concentrations of intravenous agents, as well as the pharmacodynamic effects and interactions among the anesthetic agents on the cardiovascular, respiratory, and neuroendocrine systems in the simulated patient. Of note, BODY incorporates patient age, weight and co-morbidity in the modeled response
Anesthetic effect was calculated by estimating both net analgesic level and net hypnotic level, from drug interaction models, and Aspect’s extensive clinical database. Mean BIS values were calculated from the net hypnotic level. The time variation of BIS trends stems was modulated by the predicted analgesic level. Intensity of noxious stimulation (e.g., laryngoscopy, skin incision, abdominal surgery) was estimated using the relative anesthetic requirement to prevent movement response to each stimulation. The rise in BIS, EMG and cardiovascular parameters with intraoperative stimulation was modeled from published studies and Aspect’s clinical database. The train-of-four response was estimated from the predicted concentrations of muscle relaxant. The simulated response to “perceived” stimulation (i.e., pain) from intraoperative events was created by infusing epinephrine to achieve a hemodynamic response as guided by the literature. The train-of-four level was estimated from the predicted concentrations of muscle relaxant[. Patient recovery times from cessation of volatile agent were extrapolated from published studies on recovery from BIS guided anesthesia careTCI pharmacokinetics of remifentanil are based on the Minto model while the Schneider model is used for propofol infusion
The integrated simulation environment (vaporizers, syringes, infusion devices, simulated patient monitors) as well as animations used in the simulator were created by Moberg Multimedia. 下载地址:https://www.xqnmz.com/thread-23950-1-1.html
6、Ecmo(体外膜肺氧和)模拟软件:ECMOjo 2.3.1 File size: 34.60 MB Platform: WinXP, Windows Vista, Windows Vista x64, Windows 7, Windows 7 x64
License: Open Source
Price: FREE
Released: 2011-01-20
ECMOjo is a simulator and trainer for extracorporeal membrane oxygenation. ECMOjo is a computer application implemented in Java. ECMOjo is available for all major operating systems including Windows, Macintosh, Linux and UNIX. The application consists of a graphical user interface to teach physicians, nurses and students the basics of extracorporeal membrane oxygenation. In intensive care medicine, extracorporeal membrane oxygenation (ECMO) is an extracorporeal technique of providing both cardiac and respiratory support oxygen to patients whose heart and lungs are so severely diseased or damaged that they can no longer serve their function. An ECMO machine is similar to a heart-lung machine. To initiate ECMO, cannulae are placed in large blood vessels to provide access to the patient's blood. Anticoagulant drugs are given to prevent blood clotting. The ECMO machine continuously pumps blood from the patient through a "membrane oxygenator" that imitates the gas exchange process of the lungs. Oxygenated blood is then returned to the patient.
ECMOjo has been developed by the Telehealth Research Institute (TRI), John A. Burns School of Medicine (JABSOM) of the University of Hawaii. 下载地址:https://www.xqnmz.com/thread-23153-1-1.html |