Self-Regulating Oxygen Delivery System

Lauren Ehardt Katelyn Klein Jason Nixon Advisors: Dr. Debatosh Debnath Dr. Cheryl Riley-Doucet

Outline

Introduction Problem Goals Background Benefits of Automatic Control System Design Future Plans

Introduction

Supplemental oxygen is one of the most widely used therapies for people admitted to the hospital One million COPD patients in US Manual oxygen control is the norm
[NHLBI, 2006]

Who is this?

Need for Automatic Control

No device exists to automatically regulate oxygen flow to a patient

Neonatal Environment

Manual control of oxygen delivery Patient to nurse ratio is high Lack of awareness: effects of hyper-oxygenation

[Firestone, 2007]

http://news.thomasnet.com/images/large/498/498329.jpg

Outpatient Setting

Difficult to prescribe oxygen flow rates Oxygen levels vary

Activity level Environment

[Pilling, 1999]

No set standard to determine oxygen flow rate

[Guyatt, 2000]

Project Goals

Design a self-regulating device Control oxygen flow based on SpO2 readings Automatically adjust valve opening based on pulse oximeter signal

Project Goals (contd.)

Device features

Safe Reliable Easy to use Customizable Portable Cost-effective

Oxygen Therapy: Background

Oxygen saturation Oxygen therapy patients Hyper-oxygenation Mechanisms of oxygen therapy Current research

Oxygen Saturation of Blood

Why do we need oxygen? Measured as percentage:

[ HbO 2 ] SaO2 [Total hemoglobin]
Oxygen Saturation of Arterial Blood: SaO2 = true oxygen saturation

SpO2 = measured by pulse oximeter

Normal adult SaO2 = 97-99%

[Schutz, 2001]

Hypo-oxygenation: SaO2 < 90%

[Woods, 2005]

Normal infant SaO2 = 86-92%

Oxygen Therapy Patients

Adults suffering from respiratory failure

Chronic obstructive pulmonary disease (COPD) Pneumonia Asthma Treatment: Long term oxygen therapy (LTOT) Supplemental oxygen is most common form of therapy

Neonates

[Pilling, 1999]

Hyper-oxygenation

CO2 retention
[Mack, 2006]

Neonates

Lung toxicity Brain toxicity Retinopathy of prematurity (ROP)

www.cartage.org.lb/.../humrespsys4.gif

Stevie Wonder

Suffered from Retinopathy of Prematurity

Mechanisms of Oxygen Therapy

Low flow delivery systems (0-15 lpm)

Variable performance Nasal canulla and face masks Fixed performance For respiratory assistance in addition to supplemental oxygen

High flow delivery systems (>15 lpm)

[McGloin, 2007]

www.jsdobbs.ie/jsdobbs/Main/Products_Oxygen.htm

Mechanisms of Oxygen Therapy (contd.)

Three oxygen sources

Liquid Oxygen Oxygen Cylinder Oxygen Concentrator

http://www.waldosworld.org/gallery03/oxygentank.jpg

[sunzi1.lib.hku.hk/hkjo/view/21/2100807.pdf ]

Mechanisms of Oxygen Therapy (contd.)

Oxygen flowmeter

Controls oxygen flow rate

Oxygen blender

Controls oxygen concentration and flow rate Mixes oxygen and air

http://www.gehealthcare.com/usen/suction_oxygen/oxygen_therapy/imag es/blender_c_l.jpg

Mechanisms of Oxygen Therapy (contd.)

Measuring oxygen saturation

Pulse oximetry

Non-invasive

Oximeters use alarms

www.medisave.co.uk/images/nonin-3100-pulse.jpg

[Kamat, 2002]

Current Research

Columbia Life Systems

SmartBlender

[http://smartblender.com/index.html]

Saturation Driven Oxygen Therapy (SDOT)

Computer simulation shows automatic control is more effective in maintaining constant SpO2 than manual control
[Iobbi, 2007]

Hospitals are switching to oxygen blenders

Benefits of Automatic Control

Automatic adjustment of oxygen delivery

Increases amount of time patients spend in desired SpO2 range Decreases hypo-oxygenation events

[Zhu, 2005]

Benefits (contd.)

Avoid fluctuations in SpO2

Prevent severe ROP

[Zoidis, 2007]

Improve quality of care

Lessen nurse workload

Prevent inappropriate action to reduce alarms

Fewer alarms

Project Design

HCS12 Microcontroller

Program in C Runs up to 25 MHz Pulse width modulation (PWM) controls current to the proportional valve Serial communication interface (SCI) receives data from pulse oximetry board

Pulse Oximeter Sensor

Two LEDs emit red and infrared wavelengths of light through skin

Hb absorbs red wavelengths HbO2 absorbs infrared wavelengths

Photodetector on other side picks up intensity of transmitted light SpO2 is calculated by analyzing received light Utilizes cardiac pulse to distinguish arterial blood from other mediums
Hb = hemoglobin not bound to oxygen HbO2 = hemoglobin bound to oxygen

Pulse Oximetry Board

BCI OEM 31392B1 Board

Low power Data outputs: SpO2 and pulse rate Eight second average (or instantaneous) Serial communication

Parker Proportional Valve

Parker Valve

Controls the flow based on input voltage PWM generates variable input voltage Oxygen safe

Project Design

Cost Analysis
Microcontroller
Proportional valve Oximeter board Pulse oximeter sensors Oxygen tubing

$90
$60 $135 $15 $2
($200 individual unit) ($90 individual unit)

Blenders cost $1000+

Oxygen source

$50

Project Total: $352

Progress

Literature reviews

50+ research articles

Visited respiratory therapist at Crittenton Hospital Researched valves and oximeter boards from many manufacturers Finished introduction of paper Started learning HCS12 modules

Progress (contd.)

Received valve Received oximeter board Purchased oxygen tubing from Crittenton Medical Equipment store Flow meter from Binsons Purchased helium tank Continue learning HCS12 modules

Prototype

Final Goals

Working prototype by July 16th Finish paper Create poster

Acknowledgement
We thank Kristen Munyan of Beaumont Hospital for introducing us to the problem and Steve Yax of Crittenton Hospital Medical Center for answering our questions on respiratory equipment. This work was supported in part by the Bioengineering and Bioinformatics Summer Institutes Program of the National Institutes of Health and the National Science Foundation under grant 0609152.

References

T. Croxton, HLBI and CMS launch large study of home oxygen therapy for COPD, NIH News, NHLBI Communications Office, 2006. K. Firestone and H. Adams, Evidence-based oxygen therapy for very low birth weight infants, Journal of Pediatric Nursing, vol. 22, no. 2, p. 145, 2007. G. H. Guyatt, et al., Appropriateness of domiciliary oxygen delivery, Chest, vol. 118, pp. 1303-1308, 2000. D. L. Woods, Newborn care manual, Unit 26, International Association for Maternal and Neonatal Health, 2005. J. Pilling and M. Cutaia, Ambulatory oximetry monitoring in patients with severe COPD: A preliminary study, Chest, vol. 116, pp. 314-321, 1999. E. Mack, Oxygen administration in the neonate, Newborn and Infant Nursing Reviews, vol. 6, no. 2, pp. 63-672, 006. S. L. Schutz, Oxygen saturation monitoring by pulse oximetry, AACN Procedure Manual for Critical Care, vol. 4, pp 77-82, 2001.

References (continued)

Z. Zhu, et al., Continuous oxygen monitoring- better way to prescribe long-term oxygen therapy, Respiratory Medicine, vol. 99, pp. 1386 1392, 2005. S. McGloin, Administration of oxygen therapy, Nursing Standard, vol. 22, no. 21, pp. 46-48, 2008. V. Kamat, Pulse oximetry, Indian Journal of Anaesthesia, vol. 46, no. 4, pp. 261-268, 2002. M. G. Iobbi, A. K. Simonds, and R. J. Dickinson, Oximetry feedback flow control simulation for oxygen therapy, Journal of Clinical Monitoring and Computing, vol. 21, pp. 115123, 2007. D. Zoidis, Retinopathy of prematurity: latest evidence regarding the use of supplemental oxygen, RT for Decision Makers in Respiratory Care, vol. 20, no. 1, pp. 20-22, 2007.