Sunday 13 April 2014

What is Bio Medical Engineering?

Introduction to Biomedical Engineering



Who is a Biomedical Engineer?

A Biomedical Engineer uses traditional engineering expertise to analyze and solve problems
in biology and medicine, providing an overall enhancement of health care. Students choose
the biomedical engineering field to be of service to people, to partake of the excitement of
working with living systems, and to apply advanced technology to the complex problems of
medical care. The biomedical engineer works with other health care professionals including
physicians, nurses, therapists and technicians. Biomedical engineers may be called upon in
a wide range of capacities: to design instruments, devices, and software, to bring together
knowledge from many technical sources to develop new procedures, or to conduct research
needed to solve clinical problems.

What are Some of the Specialty Areas?

In this field there is continual change and creation of new areas due to rapid advancement
in technology; however, some of the well established specialty areas within the field of
biomedical engineering are: bioinstrumentation; biomaterials; biomechanics; cellular,
tissue and genetic engineering; clinical engineering; medical imaging; orthopaedic surgery;
rehabilitation engineering; and systems physiology.

Bioinstrumentation is the application of electronics and measurement techniques to
develop devices used in diagnosis and treatment of disease. Computers are an essential
part of bioinstrumentation, from the microprocessor in a single-purpose instrument used to
do a variety of small tasks to the microcomputer needed to process the large amount of
information in a medical imaging system.

Biomaterials include both living tissue and artificial materials used for implantation.
Understanding the properties and behavior of living material is vital in the design of
implant materials. The selection of an appropriate material to place in the human body
may be one of the most difficult tasks faced by the biomedical engineer. Certain metal
alloys, ceramics, polymers, and composites have been used as implantable materials.
Biomaterials must be nontoxic, non-carcinogenic, chemically inert, stable, and
mechanically strong enough to withstand the repeated forces of a lifetime. Newer
biomaterials even incorporate living cells in order to provide a true biological and
mechanical match for the living tissue.

Biomechanics applies classical mechanics (statics, dynamics, fluids, solids,
thermodynamics, and continuum mechanics) to biological or medical problems. It includes
the study of motion, material deformation, flow within the body and in devices, and
transport of chemical constituents across biological and synthetic media and membranes.
Progress in biomechanics has led to the development of the artificial heart and heart
valves, artificial joint replacements, as well as a better understanding of the function of the
heart and lung, blood vessels and capillaries, and bone, cartilage, intervertebral discs,
ligaments and tendons of the musculoskeletal systems.

Cellular, Tissue and Genetic Engineering involve more recent attempts to attack
biomedical problems at the microscopic level. These areas utilize the anatomy,
biochemistry and mechanics of cellular and sub-cellular structures in order to understand
disease processes and to be able to intervene at very specific sites. With these capabilities,
miniature devices deliver compounds that can stimulate or inhibit cellular processes at
precise target locations to promote healing or inhibit disease formation and progression.

Clinical Engineering is the application of technology to health care in hospitals. The
clinical engineer is a member of the health care team along with physicians, nurses and
other hospital staff. Clinical engineers are responsible for developing and maintaining
computer databases of medical instrumentation and equipment records and for the
purchase and use of sophisticated medical instruments. They may also work with
physicians to adapt instrumentation to the specific needs of the physician and the hospital.
This often involves the interface of instruments with computer systems and customized
software for instrument control and data acquisition and analysis. Clinical engineers are
involved with the application of the latest technology to health care.

Medical Imaging combines knowledge of a unique physical phenomenon (sound,
radiation, magnetism, etc.) with high speed electronic data processing, analysis and
display to generate an image. Often, these images can be obtained with minimal or
completely noninvasive procedures, making them less painful and more readily repeatable
than invasive techniques.

Orthopaedic Bioengineering is the specialty where methods of engineering and
computational mechanics have been applied for the understanding of the function of bones,
joints and muscles, and for the design of artificial joint replacements. Orthopaedic
bioengineers analyze the friction, lubrication and wear characteristics of natural and
artificial joints; they perform stress analysis of the musculoskeletal system; and they
develop artificial biomaterials (biologic and synthetic) for replacement of bones, cartilages,
ligaments, tendons, meniscus and intervertebral discs. They often perform gait and motion
analyses for sports performance and patient outcome following surgical procedures.
Orthopaedic bioengineers also pursue fundamental studies on cellular function, and
mechano-signal transduction.

Rehabilitation Engineering is a growing specialty area of biomedical engineering.
Rehabilitation engineers enhance the capabilities and improve the quality of life for
individuals with physical and cognitive impairments. They are involved in prosthetics, the
development of home, workplace and transportation modifications and the design of
assistive technology that enhance seating and positioning, mobility, and communication.
Rehabilitation engineers are also developing hardware and software computer adaptations
and cognitive aids to assist people with cognitive difficulties.

Systems Physiology is the term used to describe that aspect of biomedical engineering in
which engineering strategies, techniques and tools are used to gain a comprehensive and
integrated understanding of the function of living organisms ranging from bacteria to
humans. Computer modeling is used in the analysis of experimental data and in

formulating mathematical descriptions of physiological events. In research, predictor
models are used in designing new experiments to refine our knowledge. Living systems
have highly regulated feedback control systems that can be examined with state-of-the-art
techniques. Examples are the biochemistry of metabolism and the control of limb
movements.

These specialty areas frequently depend on each other. Often, the biomedical engineer who
works in an applied field will use knowledge gathered by biomedical engineers working in
other areas. For example, the design of an artificial hip is greatly aided by studies on
anatomy, bone biomechanics, gait analysis, and biomaterial compatibility. The forces that
are applied to the hip can be considered in the design and material selection for the
prosthesis. Similarly, the design of systems to electrically stimulate paralyzed muscle to
move in a controlled way uses knowledge of the behavior of the human musculoskeletal
system. The selection of appropriate materials used in these devices falls within the realm
of the biomaterials engineer.

Examples of Specific Activities

Work done by biomedical engineers may include a wide range of activities such as:

  • Artificial organs (hearing aids, cardiac pacemakers, artificial kidneys and hearts, blood oxygenators, synthetic blood vessels, joints, arms, and legs).
  • Automated patient monitoring (during surgery or in intensive care, healthy persons in unusual environments, such as astronauts in space or underwater divers at great depth).
  • Blood chemistry sensors (potassium, sodium, O2, CO2, and pH).
  • Advanced therapeutic and surgical devices (laser system for eye surgery, automated delivery of insulin, etc.).
  • Application of expert systems and artificial intelligence to clinical decision making (computer-based systems for diagnosing diseases).
  • Design of optimal clinical laboratories (computerized analyzer for blood samples, cardiac catheterization laboratory, etc.).
  • Medical imaging systems (ultrasound, computer assisted tomography, magnetic resonance imaging, positron emission tomography, etc.).
  • Computer modeling of physiologic systems (blood pressure control, renal function, visual and auditory nervous circuits, etc.).
  • Biomaterials design (mechanical, transport and biocompatibility properties of implantable artificial materials).
  • Biomechanics of injury and wound healing (gait analysis, application of growth factors, etc.).
  • Sports medicine (rehabilitation, external support devices, etc.).

Human Physiology & Problems encountered in measuring living systems

Human Physiology & Problems encountered in measuring living systems



Human physiology is the science of the mechanical, physical, and biochemical functions of normal humans or human tissues or organs.

Physiology focuses principally at the level of organs and systems.

Major systems of Human body:

1. Cardiovascular system - can be compared to closed loop hydraulic system with a 2 synchronized isolated functioning two stage pump.

It consists of the heart and blood vessels (arteriesveinscapillaries). The heart propels the circulation of the blood, which serves as a "transportation system" to transfer oxygen, fuel, nutrients, waste products, immune cells, and signalling molecules (i.e., hormones) from one part of the body to another. The blood consists of fluid that carries cells in the circulation, including some that move from tissue to blood vessels and back, as well as the spleen andbone marrow.

2. Respiratory system - can be compared to a closed loop pneumatic system with two elastic bag and air pump to create alternatively positive and negative pressures.

The respiratory system consists of the nosenasopharynxtrachea, and lungs. It brings oxygen from the air and excretes carbon dioxide and water back into the air.

3. Nervous System - self adapting information processor with high speed communication network and a myraid of input and output channels.

The nervous system consists of the central nervous system (which is the brain and spinal cord) and peripheral nervous system. The brain is the organ of thought, emotion, and sensory processing, and serves many aspects of communication and control of various other systems and functions. The special senses consist of visionhearingtaste, and smell. Theeyesearstongue, and nose gather information about the body's environment.

Problems encountered in measuring living systems (shortcut: VIT LEAPS)

1. Inaccessibility of Variables
2. Variability of data
3. Lack of knowledge about interrelationships
4. Interaction among Physiological systems
5. Effect of Transducer on measurement
6. Artifacts
7. Energy limitations
8. Safety considerations

Biomedical [Basics] what is Action Potential?

Action Potential



Steps in Action Potential:
  1. Cell in its normal state (polarized cell) called Resting state block Na+ ions.
  2. So outside of Cell is positive wrt to inside. This potential is -70 mV
  3. When cell is stimulated the cell membrane momentarily allows Na+ ions.
  4. So inside of cell becomes positive (Depolarized cell). This is called action potential (20mV)
  5. Immediately after effect of stimulation ceases Na+ ions are transported back outside (Repolarized cell).
Conduction of action potential is rapid in mylinated axons.

How Modelling of Electrode Electrolytic Interface?

Modelling of Electrode Electrolytic Interface



Bio-potentials: Ionic voltages produced as a result of the electrochemical activity of excitable cells.

Electrodes: Transducers to convert ionic potentials into electrical potentials

Electrode Electrolytic Interface

  1. Charge separation occurs which leads to electrical double layer.
  2. Half cell potential is generated
  3. Electrolyte offers some resistance
  4. DC offset of the electrode presents some resistance.
Human body electrode Interface:

Resistance offered by epidermis layer needs to be considered

Hence to reduce the effect of body resistance

  1. use of Gel between electrode and skin
  2. Preparing the skin surface by removal of stratum corneum
Important aspects:
Electrodes – Basics
  • High-quality biopotential measurements require
    • Good amplifier design
    • Use of good electrodes and their proper placement on the patient
    • Good laboratory and clinical practices
  • Electrodes should be chosen according to the application
  • Basic electrode structure includes:
    • The body and casing
    • Electrode made of high-conductivity material
    • Wire connector
    • Cavity or similar for electrolytic gel
    • Adhesive rim
  • The complexity of electrode design often neglected
Electrodes - Basics
  • Skin preparation by abrasion or cleansing
  • Placement close to the source being measured
  • Placement above bony structures where there is less muscle mass
  • Distinguishing features of different electrodes:
    • How secure? The structure and the use of strong but less irritant adhesives
    • How conductive? Use of noble metals vs. cheaper materials
    • How prone to artifact? Use of low-junction-potential materials such as Ag-AgCl
    • If electrolytic gel is used, how is it applied? High conductivity gels can help reduce the junction potentials and resistance but tend to be more allergenic or irritating
Ag-AgCl, Silver-Silver Chloride Electrodes
  • The most commonly used electrode type
  • Silver is interfaced with its salt silver-chloride
  • Choice of materials helps to reduce junction potentials
    • Junction potentials are the result of the dissimilar electrolytic interfaces
  • Electrolytic gel enhances conductivity and also reduces junction potentials
    • Typically based on sodium or potassium chloride, concentration in the order of 0.1 M weak enough to not irritate the skin
  • The gel is typically soaked into a foam pad or applied directly in a pocket produced by electrode housing
  • Relatively low-cost and general purpose electrode
  • Particularly suited for ambulatory or long term use

Generalized Medical Instrumentation System


The major difference between this system and a conventional instrumentation system is:

The source of the signals (measurand) is a living tissue or energy is applied to living tissue.

Measurand

Physical quantity, property, or condition that is being measured by the
system.

* most important issue : accessibility
- internal (blood pressure), on body surface (ECG, EEG)
- emanate from the body (infra-red radiation)
- derived from a tissue sample (blood or biopsy)

Medically important measurands

• Biopotentials (ECG, EEG, EMG, EOG, etc.)
• Pressure, flow, dimensions (imaging)
• Displacement (velocity dx/dt, acceleration d2x/d2t, and force =
md2x/d2t)
• Impedance, temperature and chemical concentration

The measurand may be localized to a specific organ or anatomical

Sensor
* The transducer or sensor should only respond to the form of energy present in the measurand to the exclusion of all others!
* The sensor should interface with the living system to minimize the energy extracted and being minimally invasive!

Signal conditioning
Usually the sensor output can not directly drive the display, therefore
signal processing or conditioning is required

Examples of signal processing:
1. Impedance matching
2. Amplification
3. Filtering
4. Mathematical mapping
5. Linearizing
6. Analog-to-digital conversion (ADC)
7. Digital-to-analog conversion (DAC)
8. Signal averaging to reduce noise (i.e. evoked response)
9. Transformation (time domain
frequency domain)
10. Compensation for undesirable sensor characteristics
11. Etc.

Output displays
Examples of output displays:
1. Numerical
2. Graphical
3. Discrete
4. Continuous
5. Permanent or temporary

• Most displays rely on our vision, but auditory sense is also sometimes used (for example, Doppler ultrasonic signals)

• User controls and output displays should conform to human factors engineering guidelines for the design of medical devices

Auxiliary Elements
*Calibration signal with the properties of the measurand should be applied to the sensor input or as early in the signal processing chain as possible

**Many forms of feedback (automatic or manual) may be required to elicit the measurand, to adjust the sensor and signal conditioner and to direct the flow of output (display, storage, transmission)

***Data storage for signal conditioning or examination of alarm conditions or implementation of different processing algorithms

**** Data communication transmission of patient data to remote display at nurse’s station and medical center

Operation Modes

1. Direct and Indirect Modes
• Direct: Measurand directly to sensor
- readily accessible or
- acceptable invasive procedure
For example: direct blood pressure measurement

• Indirect: measurand not accessible
- Use another measurand with known relation to the desired one
- Use some form of energy or material that interacts with the
desired measurand to generate a new accessible one
For example:
Cardiac output (volume of blood pumped/min by the heart)
- Measurements of respiration & blood gas concentration
- Dye dilution
- Morphology of internal organs determined from X-rays

2. Sampling or Continuous Modes
• 
Sampling: Parameters that change slowly do not require continuous measurements

For example: body temperature, ionic concentrations, etc.

• Continuous: Parameters that change fast enough to require continuous measurements

For example: ECG, EEG, EMG, respiratory gas flow, etc.
Note: Frequency content of the measurand, the objective of the measurement, the condition of the patient and the potential liability of the physician influence how often data should be acquired

3. Generating and Modulating Sensors

• 
Generating: Produce output from energy taken directly from measurand

For example: photovoltaic cell (output voltage related to irradiation)

• Modulating: Measurand changes flow of energy from an external source that affects the output of a sensor

For example: photoconductive cell (apply external power to the sensor to measure changes in resistance with irradiation)

4. Analog and Digital Modes

• 
Analog: Continuous (parameter takes on any value within the dynamic range)

For example: Parameters that change fast enough to require continuous measurements: ECG, EEG, EMG, respiratory gas flow, etc.

• Digital: Discrete (parameter takes on a finite number of different values)

* Most sensors are analog (i.e., strain gages, thermistors, etc.)
* Very few sensors are digital in nature (i.e., shaft encoders)

5. Real-time and delayed-time Modes
Real-time: Sensors must acquire signals as they actually occur

• Output is not always displayed immediately, because some types of signal processing (i.e. averaging, transformations, etc) require considerable amount of date before production of final results

Delayed-time Often acceptable (short delays) unless urgent feedback & control depend on output

• Cell cultures provide an example where several days of delay may be required before an output is obtained!

Biomedical [Basics] what is Blood Gas analysis?

Blood Gas analysis (part 1)



Blood gas analysis, also called arterial blood gas (ABG) analysis, is a procedure to measure the partial pressure of oxygen (O2) and carbon dioxide (CO2) gases and the pH (hydrogen ion concentration) in arterial blood. Oxygen content (O2CT), oxygen saturation (SaO2) and bicarbonate (RCO3 -) values are also measured.

Blood is most commonly drawn from the radial artery because it is easily accessible, can be compressed to control bleeding, and has less risk for occlusion. The femoral artery (or less often, the brachial artery) is also used, especially during emergency situations or with children. Blood can also be taken from an arterial catheter already placed in one of these arteries.

The syringe is pre-packaged and contains a small amount of heparin, to prevent coagulationor needs to be heparinised, by drawing up a small amount of heparin and squirting it out again. Once the sample is obtained, care is taken to eliminate visible gas bubbles, as these bubbles can dissolve into the sample and cause inaccurate results.

The sealed syringe is taken to a blood gas analyzer. If the sample cannot be immediately analyzed, it is chilled in an ice bath in a glass syringe to slow metabolic processes which can cause inaccuracy. Samples drawn in plastic syringes are not iced and are analyzed within 30 minutes

Purpose

  • To evaluate gas exchange in the lungs.
  • To assess integrity of the ventilatory control system.
  • To determine the acid-base level of the blood.
  • To monitor respiratory therapy
Normal ABG values fall within the following ranges:
  • PaO2: 75 to 100 mm Hg
  • PacO2: 35 to 45 mm Hg
  • pH: 7.35 to 7.45
  • O2CT: 15% to 22%
  • SaO2: 95% to 100%
  • HCO3 -: 24 to 28 mEq/L.
pH electrode

Conventional Glass electrode
Sensitivity 59mV/pH
Use of Syringe electrodes

pCo2 electrode

Principle:

  • Conventional pH electrode covered with rubber membrane
  • water is kept in between membrane and electrode
  • Diffused Co2 mixes with water to form H2CO3
  • H2CO3 dissociates into H+ and HcO3- ions
  • This H+ ions are sensed by pH electrode

pH = log HCO3 - log k - log a - log PCO2

In commercial electrode rubber is replaced by Teflon membrane and water replaced by sodium bicarbonate solution.

Biomedical [Basics] what is Blood Gas analysis?

Blood Gas analysis (part 2)



Po2 electrode

History

Leland Clark (Professor of Chemistry, Antioch CollegeYellow Springs, Ohio, and Fels Research Institute, Yellow Springs, Ohio) had developed the first bubble oxygenator for use in cardiac surgery. However, when he came to publish his results, his article was refused by the editor since the oxygen tension in the blood coming out from the device could not be measured. This instigated Clark to develop the oxygen electrode

Principle

  • Based on Redox reaction
  • Cathode (Pt) is reduced
  • Anode (Ag/Agcl) is oxidised
  • The resulting current linearly proportional to oxygen concentration
  • Operating voltage 0.68V (Since in V I characteristics of Po2 electrode around 0.6 to 0.7V current is constant)
Construction

Membrane - Polystyrene

Complete Blood Gas Analyzer

Separate amplifier for each electrode output
Sample size : 25uL
Response time: 1 - 5 mins

Accurate measurement of following parameters
a) pH
b) pCO2
c) pO2
d) Haematocrit and Hemoglobin
e) Electrolytes Sodium,Potassium andChloride Ca++ and Magnesium
f) Lactate
g)The equipment should possess electrodes with long life at least 2 years

Electrodes placed in temperature controlled chamber