Centro Of Formazione E Simulazione Neonatale Nina

Pisa, Italy

Centro Of Formazione E Simulazione Neonatale Nina

Pisa, Italy

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Baldoli I.,Piaggio | Tognarelli S.,Piaggio | Cecchi F.,Piaggio | Scaramuzzo R.T.,Centro Of Formazione E Simulazione Neonatale Nina | And 9 more authors.
Journal of Clinical Monitoring and Computing | Year: 2014

Mechanical ventilation is a current support therapy for newborns affected by respiratory diseases. However, several side effects have been observed after treatment, making it mandatory for physicians to determine more suitable approaches. High fidelity simulation is an efficient educational technique that recreates clinical experience. The aim of the present study is the design of an innovative and versatile neonatal respiratory simulator which could be useful in training courses for physicians and nurses as for mechanical ventilation. A single chamber prototype, reproducing a pulmonary lobe both in size and function, was designed and assembled. Volume and pressure within the chamber can be tuned by the operator through the device control system, in order to simulate both spontaneous and assisted breathing. An innovative software-based simulator for training neonatologists and nurses within the continuing medical education program on respiratory disease management was validated. Following the clinical needs, three friendly graphic user interfaces were implemented for simulating three different clinical scenarios (spontaneous breathing, controlled breathing and triggered/assisted ventilation modalities) thus providing physicians with an active experience. The proposed pulmonary simulator has the potential to be included in the range of computer-driven technologies used in medical training, adding novel functions and improving simulation results. © 2013 Springer Science+Business Media.


Scaramuzzo R.T.,Centro Of Formazione E Simulazione Neonatale Nina | Scaramuzzo R.T.,Instituto Of Science Della Vita | Ciantelli M.,Centro Of Formazione E Simulazione Neonatale Nina | Baldoli I.,Sant'Anna School of Advanced Studies | And 18 more authors.
Medical Devices: Evidence and Research | Year: 2013

Respiratory function is mandatory for extra uterine life, but is sometimes impaired in newborns due to prematurity, congenital malformations, or acquired pathologies. Mechanical ventilation is standard care, but long-term complications, such as bronchopulmonary dysplasia, are still largely reported. Therefore, continuous medical education is mandatory to correctly manage devices for assistance. Commercially available breathing function simulators are rarely suitable for the anatomical and physiological realities. The aim of this study is to develop a high-fidelity mechatronic simulator of neonatal airways and lungs for staff training and mechanical ventilator testing. The project is divided into three different phases: (1) a review study on respiratory physiology and path physiology and on already available single and multi-compartment models; (2) the prototyping phase; and (3) the on-field system validation. © 2013 Scaramuzzo et al, publisher and licensee Dove Medical Press Ltd.


Tognarelli S.,Sant'Anna School of Advanced Studies | Deri L.,Sant'Anna School of Advanced Studies | Cecchi F.,Sant'Anna School of Advanced Studies | Scaramuzzo R.,Centro Of Formazione E Simulazione Neonatale Nina | And 4 more authors.
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS | Year: 2013

Nowadays, respiratory syndrome represents the most common neonatal pathology. Nevertheless, being respiratory assistance in newborns a great challenge for neonatologists and nurses, use of simulation-based training is quickly becoming a valid meaning of clinical education for an optimal therapy outcome. Commercially available simulators, are, however, not able to represent complex breathing patterns and to evaluate specific alterations. The purpose of this work has been to develop a smart, lightweight, compliant system with variable rigidity able to replicate the anatomical behavior of the neonatal lung, with the final aim to integrate such system into an innovative mechatronic simulator device. A smart material based-system has been proposed and validated: Dielectric Electro Active Polymers (DEAP), coupled to a purposely shaped silicone camera, has been investigated as active element for a compliance change simulator able to replicate both physiological and pathological lung properties. Two different tests have been performed by using a bi-components camera (silicone shape coupled to PolyPower film) both as an isolated system and connected to an infant ventilator. By means of a pressure sensor held on the silicon structure, pressure values have been collected and compared for active and passive PolyPower working configuration. The obtained results confirm a slight pressure decrease in active configuration, that is in agreement with the film stiffness reduction under activation and demonstrates the real potentiality of DEAP for active volume changing of the proposed system. © 2013 IEEE.


Baldoli I.,Piaggio | Tognarelli S.,Piaggio | Scaramuzzo R.T.,Centro Of Formazione E Simulazione Neonatale Nina | Scaramuzzo R.T.,Sant'Anna School of Advanced Studies | And 11 more authors.
Italian Journal of Pediatrics | Year: 2015

Background: Mechanical ventilation is a therapeutic action for newborns with respiratory diseases but may have side effects. Correct equipment knowledge and training may limit human errors. We aimed to test different neonatal mechanical ventilators' performances by an acquisition module (a commercial pressure sensor plus an isolated chamber and a dedicated software). Methods: The differences (ΔP) between peak pressure values and end-expiration pressure were investigated for each ventilator. We focused on discrepancies among measured and imposed pressure data. A statistical analysis was performed. Results: We investigated the measured/imposed ΔP relation. The ΔP do not reveal univocal trends related to ventilation setting parameters and the data distributions were non-Gaussian. Conclusions: Measured ΔP represent a significant parameter in newborns' ventilation, due to the typical small volumes. The investigated ventilators showed different tendencies. Therefore, a deep specific knowledge of the intensive care devices is mandatory for caregivers to correctly exploit their operating principles. © 2015 Baldoli et al.


PubMed | Sant'Anna School of Advanced Studies, University of Pisa and Centro Of Formazione E Simulazione Neonatale Nina
Type: Journal Article | Journal: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine | Year: 2015

Respiratory problems are among the main causes of mortality for preterm newborns with pulmonary diseases; mechanical ventilation provides standard care, but long-term complications are still largely reported. In this framework, continuous medical education is mandatory to correctly manage assistance devices. However, commercially available neonatal respiratory simulators are rarely suitable for representing anatomical and physiological conditions; a step toward high-fidelity simulation, therefore, is essential for nurses and neonatologists to acquire the practice needed without any risk. An innovative multi-compartmental infant respirator simulator based on a five-lobe model was developed to reproduce different physio-pathological conditions in infants and to simulate many different kinds of clinical scenarios. The work consisted of three phases: (1) a theoretical study and modeling phase, (2) a prototyping phase, and (3) testing of the simulation software during training courses. The neonatal pulmonary simulator produced allows the replication and evaluation of different mechanical ventilation modalities in infants suffering from many different kinds of respiratory physio-pathological conditions. In particular, the system provides variable compliances for each lobe in an independent manner and different resistance levels for the airway branches; moreover, it allows the trainer to simulate both autonomous and mechanically assisted respiratory cycles in newborns. The developed and tested simulator is a significant contribution to the field of medical simulation in neonatology, as it makes it possible to choose the best ventilation strategy and to perform fully aware management of ventilation parameters.


PubMed | Sant'Anna School of Advanced Studies, Centro Of Formazione E Simulazione Neonatale Nina and Piaggio
Type: | Journal: Medical engineering & physics | Year: 2016

This study describes the technical realization and the pre-clinical validation of a instrumented neonatal intubation skill trainer able to provide objective feedback for the improvement of clinical competences required for such a delicate procedure. The Laerdal


PubMed | Sant'Anna School of Advanced Studies and Centro Of Formazione E Simulazione Neonatale Nina
Type: | Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | Year: 2016

Neonatal respiratory distress syndrome (RDS) is a major cause of mortality and morbidity among preterm infants. Although the INSURE (INtubation, SURfactant administration, Estubation) technique for surfactant replacement therapy is so far the gold standard method, over the last years new approaches have been studied, i.e. less invasive surfactant administration (LISA) or minimally invasive surfactant therapy (MIST). Here we propose an originally modified MIST, called CALMEST (Catheter And Laryngeal Mask Endotracheal Surfactant Therapy), using a particular laryngeal mask as a guide for a thin catheter to deliver surfactant directly in the trachea.We performed a preliminary study on a mannequin and a subsequent in vivo pilot trial.This novel procedure is quick, effective and well tolerated and might represent an improvement in reducing neonatal stress. Ultimately, CALMEST offers an alternative approach that could be extremely useful for medical staff with low expertise in laryngoscopy and intubation.


PubMed | Centro Of Formazione E Simulazione Neonatale Nina and Piaggio
Type: | Journal: Italian journal of pediatrics | Year: 2015

Mechanical ventilation is a therapeutic action for newborns with respiratory diseases but may have side effects. Correct equipment knowledge and training may limit human errors. We aimed to test different neonatal mechanical ventilators performances by an acquisition module (a commercial pressure sensor plus an isolated chamber and a dedicated software).The differences (P) between peak pressure values and end-expiration pressure were investigated for each ventilator. We focused on discrepancies among measured and imposed pressure data. A statistical analysis was performed.We investigated the measured/imposed P relation. The P do not reveal univocal trends related to ventilation setting parameters and the data distributions were non-Gaussian.Measured P represent a significant parameter in newborns ventilation, due to the typical small volumes. The investigated ventilators showed different tendencies. Therefore, a deep specific knowledge of the intensive care devices is mandatory for caregivers to correctly exploit their operating principles.

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