"Information for Informatics: Cardiac Biophysical Monitoring"

Dr. Michael R. Neuman

Abstract

Medical informatics includes many different types of data ranging from patient medical histories through complex images. In this tutorial lecture we will look at biophysical data taken as diagnostic measurements, therapeutic monitoring, and assessment of rehabilitation. A patient's electronic medical record is not complete without such data, yet much of the time only its interpretation is documented. An important factor in collecting and archiving this data is understanding how it is collected. We will review the types of biophysical data that are taken and recorded and look at the sensors and instrumentation used to collect this data as well as present some recent work being carried out in our laboratory. The four vital signs present important information for any clinical encounter, and two of these, heart rate and blood pressure, are important assessments of the cardiovascular system. Techniques to obtain this information as sampled data or on a continuous basis will be described. Cardiac monitoring devices for ambulatory and in-hospital monitoring are also important for identifying significant cardiac arrhythmias. The signals from this instrumentation can be also analyzed to, in some cases, assess clinical prognosis using techniques such as quantifying heart rate variability. The non-invasive and continuous measurement of blood pressure is one of the more difficult yet clinically significant biophysical measurements, and techniques to do this will be described. Finally, we will consider cardiac output, blood flow, and tissue perfusion as important measurements where improved techniques are still needed.