Anesthetic Device Research Articles

Creation and Preclinical Testing of a Spirometer with Extended Functionality

RELEVANCE. We present the results of preclinical testing of an upgraded portable AR­1 gas flow analyzer produced by JSC Krasnogvardeets (Saint Petersburg) in order to create import-substituting technologies and develop practical and scientific spheres of healthcare.THE AIM OF THE STUDY. was to substantiate the possibility of clinical use of the upgraded device, originally intended for testing ventilators and inhalation anesthesia devices, as a monitor of the external respiration apparatus function.MATERIAL AND METHODS. The preclinical study of the upgraded gas flow analyzer was conducted at the V.A. Almazov National Medical Research Center in comparison with devices for conventional (Bellavista 950, Berner Ross Medical, Russia) and high-frequency (IPV-2C, Intrapulmonary Percussive Ventilation, Percussionaire Corporation, USA) mechanical ventilation in volume- and pressure-controlled modes using an artificial lung. The following reflected spirometry parameters were compared: tidal and minute volume under inhalation and exhalation, respiratory rate, maximum and minimum flows, peak and positive end expiratory pressure, fraction of inspired oxygen.RESULTS. A high accuracy of parameter matching shown by the gas flow analyzer and ventilators was demonstrated.CONCLUSION. The upgraded model of the gas flow analyzer can be used clinically as a portable spirometer at the prehospital and hospital stages.

Efficacy of computer-controlled local anesthesia delivery system on pain in dental anesthesia: a systematic review of randomized clinical trials.

Computer-controlled local anesthesia delivery (CCLAD) is an innovative electronic injection device that represents a cutting-edge approach to dental anesthesia. This system is promising for painless anesthesia using controlled anesthetic injections. This review aimed to compare the discomfort experienced by patients during local anesthesia using a traditional syringe and the CCLAD system and evaluate the potential of the CCLAD system as a painless dental anesthesia solution. The inclusion criteria for this study were based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The study population, including children and adults, underwent dental anesthesia using the CCLAD system, ensuring a comprehensive and representative sample that instills confidence in the validity of the results. Fourteen clinical trials were included in the analysis after they fulfilled the eligibility criteria. We found that using computer-assisted anesthetic equipment not only led to a significantly lower pain perception score, but also had a profound positive impact on patient behavior. Patients using the CCLAD device exhibited more cooperative and helpful conduct, indicating the system's effectiveness in improving patient comfort and experience and reassuring the audience about its positive impact. In conclusion, using a computer-assisted anesthetic device such as the CCLAD system significantly reduced pain perception scores and improved patient behavior, making them more cooperative and helpful. These findings offer hope for pediatric dentistry and apprehensive adult patients, suggesting a more comfortable and less daunting dental experience with the CCLAD system.

Automated Capsular Decompression to Avoid Argentinian Flag Sign in Intumescent Cataract.

We describe an alternative automated technique that consists of simultaneous anterior capsule puncture and decompression of the capsular bag by using an insulin needle attached to the aspiration tubing of the phacoemulsification device to prevent the occurrence of the "Argentinian Flag sign" during capsulorhexis in intumescent cataract. Instituto de Olhos de Assis and Center of Specialties Hoftalmed, located in the state of São Paulo, Brazil. Prospective interventional study. Eighty-eight eyes of 88 patients with white or intumescent cataracts were included in this study. Routine clear cornea incision, capsule staining with trypan blue, intracameral anesthesia, and ophthalmic viscoelastic device were used before the procedure. A 26-gauge needle was connected to the phacoemulsification aspiration tubing using a double male Luer connector for irrigation, and aspiration was inserted into the anterior chamber through a new paracentesis incision with the bevel facing down. Immediately after insertion, automated aspiration of the liquefied cortex was performed to remove anterior intralenticular material and achieve capsular decompression. Compression of the nucleus with the needle tip was performed to remove any liquefied material trapped between the posterior surface of the nucleus and the posterior capsule. All surgeries were performed using the same phacoemulsification and parameters. The rate of complete continuous capsulorhexis was observed and noted. No complications were observed in any of the cases. A single-stage, continuous, and well-centered capsulorhexis was achieved in 100% of cases. We conclude that a simultaneous puncture and decompression of the capsular bag using an insulin needle attached to the aspiration tubing of the phacoemulsification machine effectively avoided the "Argentinian Flag sign" in intumescent cataract surgery.

Investigating visual preferences of clinical mechanical anesthetic vibration: a cross-sectional image survey.

While mechanical vibration lessens discomfort associated with injection site pain (ISP), many local anesthetic injectors (LAIs) do not use vibratory anesthetic devices (VADs). Injector preference of vibration device is influenced by functional concerns, but qualitatively there is an element of adoption that is driven by visual feedback. We sought to capture operator preferences of vibration device design elements to further understand why injectors do not use these devices. We conducted a survey of image preferences among nurses and medical assistants employed at 8 dermatological clinics to investigate barriers to VAD use. Images were electronically modified with features distinct from the original device (a VAD commonly used in clinical practice). Participants rated their likelihood and comfort of use of each VAD represented in the images. Two-sample t-tests were used to compare the rating of the unmodified VAD to each modified VAD within participants. A response rate of 100% was achieved with 35 participants (average age, 38.5 years; 6 (17.1%) male, 29 (82.9%) female). Despite 28 (80%) participants knowing that mechanical vibration reduces ISP, only 16 (45.7%) endorsed ever using mechanical vibration as topical anesthetic. Images modified by pattern, color, and sterility covering were rated significantly lower than the original, unmodified VAD image (plain white VAD), confirming that visual feedback does impact adoption. Through independent comment categorization, aesthetics were found to be important to LAIs. Aesthetic preferences opposing functional concerns may factor into the lack of VAD use. Defining these visual preference barriers to adoption may help promote VAD use during dermatologic procedures.

A Case Report on Use of Anesthetic Conserving Device in a Patient with Bullous Cystic Lung Disease

A Case Report on Use of Anesthetic Conserving Device in a Patient with Bullous Cystic Lung Disease

A prospective randomized trial comparing the efficacy of temperature-responsive gel with local anesthetics versus local anesthetic infusion pump device for postoperative pain control after bariatric surgery.

Bariatric surgery is the gold standard for the treatment of morbid obesity, but postoperative pain impedes recovery. Currently available pain-recovery treatments have patient safety concerns. This led to a noninferiority study of Welpass (Genewel Co., Ltd.) vs. On-Q PainBuster (B. Braun), each used alongside a traditional method of continuous local anesthetic administration, in patients undergoing bariatric surgery. In this single-center prospective randomized clinical trial, patients were assigned in a 1:1 ratio to the treatment group (Welpass) and the control group (On-Q PainBuster), with ketorolac administered as needed after surgery according to the protocol. To assess efficacy, the total amount of ketorolac used up to 72 hours postoperatively was measured. Additionally, ketorolac usage and numerical rating scales (NRS) were recorded at 6, 24, 48, and 72 hours after operation. The total amounts of ketorolac used in the 72 hours postoperatively were 188.0 ± 84.6 mg in the treatment group and 198.7 ± 50.0 mg in the control group. The efficacy of the treatment group was noninferior to that of the control group, since the lower limit (-29.9 mg) of the confidence interval for the difference with the control group was greater than the prespecified noninferiority margin (-35.0 mg). Furthermore, when the NRS was evaluated after bariatric surgery, there was no significant difference in scores between the 2 groups at each time point (P > 0.05). We found no difference in effect on pain between the 2 groups, supporting the use of Welpass in clinical practice for pain management in patients undergoing bariatric surgery.

Contamination of equipment and surfaces in the operating room anesthesia workspace: a cross-sectional study.

Contamination of the breathing circuit and medication preparation surface of an anesthesia machine can increase the risk of cross-infection. To evaluate the contamination of the anesthetic medication preparation surface, respiratory circuits, and devices used in general anesthesia with assisted mechanical ventilation. Cross-sectional, quantitative study conducted at the surgical center of a philanthropic hospital, of medium complexity located in the municipality of Três Lagoas, in the eastern region of the State of Mato Grosso do Sul. Eighty-two microbiological samples were collected from the breathing circuits. After repeating the samples in different culture media, 328 analyses were performed. A higher occurrence of E. coli, Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, and Streptococcus pneumoniae (P < 0.001) were observed. Variations were observed depending on the culture medium and sample collection site. The study findings underscore the inadequate disinfection of the inspiratory and expiratory branches, highlighting the importance of stringent cleaning and disinfection of high-touch surfaces.

Novel dental anesthetic and associated devices: a scoping review.

The efficient management of pain and discomfort is essential for successful dental treatment and patient compliance. Dental professionals are commonly evaluated for their ability to perform treatment with minimal patient discomfort. Despite advancements in traditional local dental anesthesia techniques, the pain and discomfort associated with injections remain a concern. This scoping review aims to provide a comprehensive overview of the literature on novel dental anesthetics and associated devices designed to alleviate pain and discomfort during dental procedures. The Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines were used to prepare the review. Six databases and two sources of gray literature were searched. This review analyzed 107 sources from 1994 to 2023. Local anesthesia devices were grouped into computer-controlled local anesthetic delivery (CCLAD) systems, intraosseous anesthesia (IOA), vibratory stimulation devices, and electronic dental anesthesia (EDA). CCLAD systems, particularly the Wand and Single-Tooth Anesthesia, have been the most researched, with mixed results regarding their effectiveness in reducing pain during needle insertion compared to traditional syringes. However, CCLAD systems often demonstrated efficacy in reducing pain during anesthetic deposition, especially during palatal injections. Limited studies on IOA devices have reported effective pain alleviation. Vibrating devices have shown inconsistent results in terms of pain reduction, with some studies suggesting their primary benefit is during needle insertion rather than during the administration phase. EDA devices are effective in reducing discomfort but have found limited applicability. These findings suggest that the CCLAD systems reduce injection pain and discomfort. However, the evidence for other devices is limited and inconsistent. The development and research of innovative technologies for reducing dental pain and anxiety provides opportunities for interdisciplinary collaboration and improved patient care in dental practice.

Standardization of the Extent and Timing of Rectus Diastasis Repair in Abdominoplasty Cases with TOF Neuromuscular Monitoring: A Clinical Study.

Despite the close focus on the anterior abdominal wall and the classification, maneuvers and materials related to the rectus abdominis and its fascia, there is no established standard concerning the extent of plication. The anterior abdominal wall is a musculoaponeurotic structure and a dynamic motor system with innervation and tonus. Therefore, the timing of the plication is as important as the suture technique and material, since the muscle relaxant will lose its effect in varying time periods. The aims of our study were to determine the change in the amount of plication between groups with and without muscle relaxants before plication and whether the amount of this change can be standardized using train-of-four (TOF) monitoring. In 2022 and 2023, 12 women aged between 25 and 48 years with a body mass index between 24 and 38 years were included in the study. Neuromuscular blockade was monitored by train-of-four (TOF) monitoring in all patients. Maximum plication areas at above-zero TOF value and zero TOF value were calculated and compared with each other. The reduction in the area of group 1, which represents the phase without muscle relaxant, and group 2, which represents the phase with neuromuscular blockade, were compared using the t-test. When assessed for above-zero TOF, the area between plication lines (a, a') was always smaller than the area between the plication lines (b, b') when the TOF value was zero. The t test comparison of group 1, which includes (a, a') values, and group 2, which includes (b, b') values, resulted in a value of p = 0.000. All cases, the plication value obtained with above-zero TOF value was lower than the plication value when the TOF value was zero. This difference was also confirmed statistically on a group basis. This suggests that neuromuscular measurements should be taken during the plication phase in the routine flow of surgery. Muscle relaxants are not routinely administered to patients undergoing abdominoplasty or rectus diastasis repair who are already under sufficient analgesia, unless there is a pressure alert on the anesthesia device. The surgeon cannot always determine the degree of muscle laxity accurately by palpation. TOF monitoring is a cost-effective quantitative method that can be easily and quickly performed, accurately determining the timing of muscle-fascia plication of the rectus abdominis. Through this approach, the anterior abdominal wall can be plicated with maximum tightness and maximum aesthetic gain can be obtained.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Prospective Cohort Study to Evaluate Needle Passes Using a Portable Ultrasound Device versus Traditional Landmark Approach for Epidural Anesthesia in a Busy Obstetric Tertiary Care Center

Despite its many cited benefits, ultrasound guidance for neuraxial procedures is not widespread in anesthesiology. Some cited limitations include device cost and accessibility. We test the hypothesis that a handheld and relatively inexpensive ultrasound can improve neuraxial proficiency (e.g., decreased needle manipulations and block time). This prospective study compared the number of needle passes, redirections, and procedural time between epidural placed with a handheld ultrasound versus landmarks. Needle passes and attempts were defined as the number of times the Tuhoy needle was redirected, and the times skin was punctured (re-insertion). Procedural time was defined as the time from local anesthetic infiltration until loss of resistance was obtained. The impact of level of training and accuracy of the device were also analyzed. 302 patients receiving labor epidural were included in the study. No difference in body mass index (BMI) nor distribution of level of training was noted between the groups. Regression analysis adjusted for BMI demonstrated a decrease in needle passes (-1.75 (95% CI -2.62, -0.89), p &lt; 0.001), needle attempts (-0.51 (95% CI -0.97, -0.04), p = 0.032) and procedural time (-154.67s 95% CI -303.49s, -5.85s), p = 0.042) when a handheld ultrasound was utilized. The mean (95% Confidence interval) difference between needle depth and ultrasound depth was 0.39 cm (0.32, 0.46), p &lt; 0.001. The use of a handheld device resulted in statistically significant decrease of needle manipulations and block time. More research is needed to evaluate the impact of and increase in accessibility of ultrasound technology.

Anesthetic management of difficult paediatric airway in a case of large facial Neurofibromatosis – A case report

Neurofibromatosis is tumor involving different parts of the body. Neurofibromatosis may potentially lead to difficult airway. These challenging cases need special considerations. Various anesthetic techniques and devices are described to secure the airway. In the present case we intubated a 11-year-old child with large left side facial tumor extending to the neck which had intraoral encroachment displacing the tongue and pharynx to the right. This is a case report illustrating intubation of difficult pediatrics airway using awake bronchoscopic intubation under conscious sedation.

Beyond Needles and Syringes: A Review of Innovations in Local Anaesthesia Administration in Dentistry

Efficient pain and discomfort management in oral health is crucial, as they can act as barriers to effective dental care delivery (Al-Omari &amp; Al-Omiri, 2009). Oral health practitioners who poorly manage pain and discomfort can potentially initiate fear and a negative attitude towards dental treatment. Local anaesthesia is vital in pain and discomfort control during dental procedures. Traditionally, it is administered using a needle and syringe, a method that causes pain upon injection (Yesilyurt et al., 2008). In response, innovative technologies have been introduced to reduce pain and discomfort during local anaesthesia administration. Numerous techniques have been examined to minimise injection pain, including slowing the injection rate, pre-warming the solution, and using narrow or sharp needles. However, despite these advancements, achieving a completely painless injection remains a significant challenge (Yesilyurt et al., 2008). The increasing recognition of this challenge has prompted research into alternative methods and supplementary aids, including devices that make administering dental local anaesthesia less painful. While previous studies have reported the effectiveness of specific technologies, such as computer-controlled local anaesthesia devices, compared to conventional needles and syringes, investigations of other emerging devices and technologies designed to reduce discomfort during dental anaesthesia administration are lacking. Therefore, a scoping review will be performed, adhering to the guidelines of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) (Aromataris &amp; Munn, 2020). This scoping review will systematically map the existing body of knowledge related to various local anaesthesia techniques and their associated devices developed to minimise pain during dental procedures. Moreover, as detailed in the existing literature, it will capture their defining characteristics and role in reducing pain during dental procedures. It will identify common themes and gaps in current knowledge to guide future research priorities.

Exposure to anesthetic gases in the operating rooms and assessment of non-carcinogenic risk among health care workers

Health care workers employed operating room in hospital and health centers are unavoidably exposed to inhaling toxic gases, including isoflurane and sevoflurane. Chronic contact with these gases increases the risk of spontaneous abortion, congenital anomalies and cancers. Risk assessment is an important tool in predicting the possible risk to personnel's health. Therefore, this study was conducted with the aim of determining the concentration of isoflurane and sevoflurane gas in the air of the operating room and estimating the non-carcinogenic risk caused by them. In this descriptive-cross-sectional study, according to the occupational method (OSHA 103), 23 samples (isoflurane and sevoflurane) were collected in the air of operating rooms of four selected hospitals in Ahvaz city by using SKC sampling pumps and sorbent tube (Anasorb 747). The samples were determined by used to gas chromatography with a flame ionization detector (GC/FID). Statistical analysis, including the Kruskal-Wallis test, was used to compare the average concentration of anesthetic gases, and the one-sample t-test was used to compare the average with the standard level. In all analyses, the significance level was 0.05, which was performed by SPSS version 22 software. Result of this study showed that the average concentration of isoflurane in private and general hospitals were 23.636 and 17.575 ppm, respectively. Also, the average level of sevoflurane were 1.58 and 7.804 ppm. According to the results the mean amount of anesthetic gases was within the range recommended by Iran's Occupational and Environmental Health Center and the permissible threshold limit provided by ACGIH. In addition, non-cancer risks from occupational exposure to isoflurane and sevoflurane in selected private and general hospitals were acceptable (HQ < 1). Although the results show that overall occupational exposure to anesthetic gases is less than acceptable but long-term exposure to anesthetic gases may endanger the health of operating room staffs. Therefore, it is recommended to implement some technical controls, including regular inspection of ventilation systems, the use of advanced ventilation systems with high cleaning power, continuous control of anesthesia devices in terms of leakage, and periodic training of related staff.

Field trial: disinfection of contaminated anesthetic masks for piglets

This paper aimed to assess the success of cleaning and disinfection on microbiological contamination of anesthetic masks, which were used for automated isoflurane anesthesia for surgical castration of male piglets. Data collection took place on 11 farms in Southern Germany between September 2020 and June 2022. Each farm was visited three times (one farm having two different anesthesia devices was visited six times), and microbiological assessments took place at four sample points (SP): after unpacking the masks (SP0), after disinfection before anesthesia (SP1), after anesthesia of all piglets to be castrated in this run (SP2), and after disinfection after anesthesia (SP3). The microbiological assessment included the determination of total bacteria count, total count of hemolytic and non-hemolytic mesophilic aerotolerant bacteria and a qualitative detection of indicator bacteria Escherichia (E.) coli, extended-spectrum beta-lactamase-producing E. coli (ESBL) and methicillin-resistant Staphylococcus aureus (MRSA). For analysis, a generalized linear mixed model was applied using farms and farm visits as random effects and sampling points nested in farm visits as fixed effect. The fixed effect was highly significant for all three variables (total bacteria count, total count of hemolytic and non-hemolytic mesophilic aerotolerant bacteria) (p < 0.001). The bacterial counts at SP0 were about the same as at SP3. Concerning indicator bacteria, their presence was highest at SP2 and lowest at SP3. No indicator bacteria were present at SP1. It can be concluded that disinfection of anesthetic masks, especially before performing anesthesia, may effectively protect piglets of the following batch against unwanted transmission of pathogens. These findings will help farmers plan cleaning and disinfection activities.

Perfect Preparation.

Perfect Preparation.

Evaluation of an automatic approach device to the epidural space of Beagle dogs

ObjectiveTo compare the epidural anesthesia device (EPIA), which facilitates an automatic approach to location of the epidural space, with the performance of clinicians using tactile sensation and differences in pressure when inserting an epidural needle into the epidural space of a dog. Study designProspective, crossover experiment. AnimalsA total of 14 Beagle dogs weighing 7.5 ± 2.4 kg (mean ± standard deviation). MethodsEach dog was anesthetized three times at 2 week intervals for three anesthesiologists (two experienced, one novice) to perform 14 epidural injections (seven manual and EPIA device each). The sequence of methods was assigned randomly for each anesthesiologist. The dogs were anesthetized with medetomidine (10 μg kg–1), alfaxalone (2 mg kg–1) and isoflurane and positioned in sternal recumbency with the pelvic limbs extended cranially. Epidural puncture in the manual method was determined by pop sensation, hanging drop technique and reduced injection pressure, whereas using the device a sudden decrease in reaction force on the device was detected. A C-arm identified needle placement in the epidural space, and after administration of iohexol (0.3 mL), the needle length in the epidural space was defined as the mean value measured by three radiologists. Normality was tested using the Kolmogorov–Smirnov test, and significant differences between the two methods were analyzed using an independent sample t test. ResultsIn both methods, the success rates of epidural insertion were the same at 95.2%. The length of the needle in the epidural space using the device and manual methods was 1.59 ± 0.50 and 1.68 ± 0.88 mm, respectively, with no significant difference (p = 0.718). Conclusions and clinical relevanceEPIA device was comparable to human tactile sense for an epidural needle insertion in Beagle dogs. Further research should be conducted for application of the device in clinical environments.

Comparative study of two different computer-controlled local anesthesia injection systems in children: a randomized clinical trial.

To compare pain perception associated with two computer-controlled local anesthesia devices, the WAND™ STA (Milestone Scientific Inc., Livingston, NJ, USA) and the Calaject (Rønvig dental MFG, Daugaard, Denmark) in young children. A split-mouth randomized clinical trial comprising 30 patients, aged 6-12years, received randomly, in two separate sessions, a local anesthesia injection in the maxillary using either the wand STA or the Calaject. Pain perception was evaluated using the patient's heart rate, an 11-point numerical scale (NRS), and the Sound, Eye, and Motor (SEM) body movements. Statistical difference was set at p = 0.05. Repeated measures analysis of variance were conducted to compare the mean pulse for Calaject and STA at different times. It was followed by univariate analysis and Bonferroni multiple comparisons tests. Wilcoxon tests were performed to compare NRS, SEM, and injection duration between Calaject and STA. There was no significant statistical difference between Calaject and STA in pulse rate before injection (p = 0.720), during injection (p = 0.767), and after injection (p = 0.757). The mean NRS score was significantly greater with STA in comparison with Calaject (p = 0.017). The mean SEM score was also significantly greater with STA in comparison with Calaject (p = 0.002). However, the mean duration was significantly longer with Calaject (p = 0.001). Calaject was more effective than STA in reducing pain perception associated with periapical injection in young children.

The Effects of Low Flow and Normal Flow Desflurane Anesthesia on Liver and Renal Functions and Serum Cystatin C Levels in Geriatric Patients: A Prospective Randomized Controlled Study

Introduction: Aging is a physiological process and the elderly population is increasing. In parallel to the increasing of the elderly population, the number of geriatric patients who required an invasive procedure or surgical intervention under anesthesia are also increasing. The geriatric patients who are frailty and have a loss of functional reserve in all organ systems are more sensitive to anesthetic agents. The purpose of this research was to investigate whether low flow desflurane anesthesia also affects hepatic and kidney functions, in elderly patients. Methods: After approval from the local ethics committee, the patients were divided into two groups; as the low flow desflurane anesthesia group and the normal flow desflurane anesthesia group using the closed-envelope method. Calibration and leakage tests of the anesthesia device (Primus, Drager) were performed before anesthesia. Heamodynamics parametres, peripheral oxygen saturation, and bispectral index monitoring were performed to all patients in operating room. The blood samples were collected before anesthesia induction, after surgery, and at the postoperative 24th hour. The serum alanine aminotransferase and aspartate aminotransferase levels were measured to assess the liver damage. The serum creatinine, blood urea nitrogen, and cystatin C levels were measured to assess the kidney function. Results: The serum alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and cystatin C levels and hemodynamic parameters, peripheral oxygen saturation and bispectral index values were similar in both groups. Conclusions: It was concluded that low-flow desflurane anesthesia does not adversely affect liver and kidney functions in geriatric patients and is as safe as normal-flow desflurane anesthesia. Keywords: Anesthesia; Cystatin C; Desflurane; Aged; Kidney; Liver.

Electrical modeling and characterization of the faulty state of the artificial ventilators

This paper presents an electrical model for detection and diagnosis of different types of faults that mostly occur in the intensive care devices as well as anesthesia devices. This simplified model, that includes the one-compartment CR model for the respiratory system, is well-described in such manner the maintenance agent should gain an understanding of the artificial ventilator basics without any deep medical knowledge or advanced medical staff contribution. Also, presenting the electrical-pneumatic system analogy can significantly help electronics and electrical engineers to wellunderstand how the ventilator is working and what are the crucial parameters that should be monitored. In the context of the maintenance field action, the model is able to predict the ventilator waveforms abnormality and then help to predict failure in the ventilator itself that lead to helping the IA researcher to think for suitable algorithms for predictive maintenance of medical devices. The model is mathematically described and the circuit is then simulated in Cadence Virtuoso Platform using 130 nm technology. The validity of the proposed model has been assessed using a real ICU ventilator connected to an artificial lung test and running VCV mode.

Application the Risk-Based Maintenance for Optimizing the Overall Medical Devices Safety

The purpose of this study was to identify risks to patients as a result of sudden device failure during the delivery of medical treatment services. Which, can affect the reputation of hospitals following the exposure of patients' lives to various risks like death, injury, and misdiagnosis. Furthermore, a sudden failure will lead to increased economic losses as a result of increased maintenance costs. Of (20) medical devices, (6) high-risk devices were selected, such as a ventilator, diathermy, anesthesia, BiPAP, oxygen concentrator, and electrosurgical devices. A quantitative statistical analysis based on risk-based maintenance is used to evaluate the effectiveness of the reliability of the medical device and its risks to patient lives. The results show that the reliability of the chosen medical device has declined, with higher maintenance costs due to excessive maintenance or the type of maintenance policy used. Therefore, this study provides evidence that hospitals must adopt a risk-based maintenance approach to prevent sudden failure while in service. In addition, these medical devices have various complex parts that must adopt a combination of maintenance schedules. Based on Risk-Based Maintenance's experience in improving patient safety in public hospitals in the 20 most successful OECD countries.