1. Procedure to Measure and Control Blood Oxygen Saturation Levels in Premature Infants Team: Jean Pappalardo Trent Roszell Payal Sehgal Advisors: Dr. John Penn Dr. Kendall Graham Dr. Paul King

2. Project Goal To design software that will recognize trends in SaO2 levels & recommend a correlating FiO2 level for premature infants. To design software that will recognize trends in SaO2 levels & recommend a correlating FiO2 level for premature infants.

3. What causes Retinopathy? ROP is an abnormality of the eye that leads to blindness. When an infant is born prematurely, abnormal blood vessels may develop which can lead to leaking, scar tissue formation, and retinal detachment. All of these symptoms contribute to the possibility of blindness. There is a relationship between the administration of supplemental oxygen and the onset of ROP. High levels of 02 are especially associated with this disorder (Penn, 1995) Extreme variation in Sa02, especially after the first week of birth, is strongly linked with the onset of blindness in laboratory mice (Penn, 1995)

4. Retinopathy Statistics Of the 3.9 million babies born each year in the United States, 11.5% are premature. Of the 3.9 million babies born each year in the United States, 11.5% are premature. 3800 babies develop retinopathy every year. 3800 babies develop retinopathy every year. ROP is reported to develop in 84% of premature survivors born at <28 weeks gestation ROP is reported to develop in 84% of premature survivors born at <28 weeks gestation Median cost of treatment was $49,457.00 with an average stay of 49 days Median cost of treatment was $49,457.00 with an average stay of 49 days

5. Current Standard of Care A Respiratory Gas Monitor (RGM), or pulse oximeter, measures the percentage of oxygenated blood by passing light through the subject’s finger A Respiratory Gas Monitor (RGM), or pulse oximeter, measures the percentage of oxygenated blood by passing light through the subject’s finger A RGM is non-invasive, but prone to signal noise from ambient light or movement A RGM is non-invasive, but prone to signal noise from ambient light or movement

6. Current Standard of Care Infants’ blood oxygen level is monitored by a RGM. Infants’ blood oxygen level is monitored by a RGM. Oxygen flow into the incubator is manually adjusted by a nurse when blood oxygen is too low or too high Oxygen flow into the incubator is manually adjusted by a nurse when blood oxygen is too low or too high

7. Problems With Current Standard of Care Studying the data provided by Dr. Graham, it is clear that oxygen levels vary greatly Studying the data provided by Dr. Graham, it is clear that oxygen levels vary greatly Alarms are in place, but only under life threatening oxygen levels Alarms are in place, but only under life threatening oxygen levels Alarms trigger only when SaO2 drops below 80% or above 98% Alarms trigger only when SaO2 drops below 80% or above 98%

8. Sample Data

9. Focusing on the problem Software that assists medical personnel in the monitoring of Sp02 trends should lead to a lower occurrence of blindness in newborns Software that assists medical personnel in the monitoring of Sp02 trends should lead to a lower occurrence of blindness in newborns

10. Project Overview Work Completed Collected data on five premature infants Collected data on five premature infants Patent search reveals that a computer program designed to monitor RGM trends has not yet been marketed Patent search reveals that a computer program designed to monitor RGM trends has not yet been marketed A control scheme, relying on basic principles of fuzzy logic, has been selected over feedback-loop analysis. A control scheme, relying on basic principles of fuzzy logic, has been selected over feedback-loop analysis.

11. Project Overview Current Work Implementing Fuzzy logic control scheme into Labview Implementing Fuzzy logic control scheme into Labview Writing Labview VI(virtual instrument) to read in data and suggest an appropriate FI02 level Writing Labview VI(virtual instrument) to read in data and suggest an appropriate FI02 level

12. Future Work Using Labview input/output VI, input data from the RGM Using Labview input/output VI, input data from the RGM Integrate fuzzy logic parameters into a Labview VI to dictate appropriate adjustments Integrate fuzzy logic parameters into a Labview VI to dictate appropriate adjustments

13. Proposed Flowchart

14. References Penn JS, Henry MM, Tolman BL and Wall PT (1995) The range of PaO2 variation determines the severity of oxygen-induced retinopathy in newborn rats. Penn JS, Henry MM, Tolman BL and Wall PT (1995) The range of PaO2 variation determines the severity of oxygen-induced retinopathy in newborn rats. http://www.infoplease.com/askeds/8-2- 00askeds.html http://www.infoplease.com/askeds/8-2- 00askeds.html http://www.infoplease.com/askeds/8-2- 00askeds.html http://www.infoplease.com/askeds/8-2- 00askeds.html http://129.59.92.139/srdesign/1999/gro up8_99/oral3.ppt http://129.59.92.139/srdesign/1999/gro up8_99/oral3.ppt http://129.59.92.139/srdesign/1999/gro up8_99/oral3.ppt http://129.59.92.139/srdesign/1999/gro up8_99/oral3.ppt