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Engineering Safer Surgery

New system improves patient monitoring

An electrical engineer known for his contributions to the pulp and paper industry, and a doctor who has pioneered safer pediatric anesthesiology practices would seem to have little in common. But Guy Dumont and Mark Ansermino have combined their talents to create medical technologies that are helping save lives.

The successful combination of the two skill sets finds its roots in the most unlikely of places, a squash court. Several years ago, a postdoctoral fellow studying with Dr. Dumont struck up a conversation with an anesthesiology student during a friendly game. The fellow shared ideas generated by the conversation with Dr. Dumont, piquing the interest of his professor, who then began organizing formal discussions to explore a new research direction. One name stood out as a potential collaborator: Mark Ansermino.

The end result of the original off-the-cuff conversation is an innovative technology that merges electrical engineering techniques with anesthesiology. This achievement has earned Drs. Dumont and Ansermino, both of the University of British Columbia, the Brockhouse Canada Prize for Interdisciplinary Research in Science and Engineering from NSERC. Together they developed the Intelligent Anesthesia Navigator (IAN)—a set of tools that greatly enhance anesthesiologists' ability to monitor patients during an operation.

Anesthesiologists must track a complex array of sensor data during an operation. Any tool that can make the process simpler and more effective will reduce the number of adverse events that can harm or even kill patients.

"As a clinician, I want to use technologies that can make me better at what I do," says Dr. Ansermino. "As a researcher, I have a keen interest in making sure technology is introduced in a way that has no risk for patients and that allows doctors to be at their best."

Proven in clinical trials, the IAN's features reduce false alarms and flag problems earlier than existing technologies. The system raises an alert by transmitting a message through vibrations from a waist belt, rather than using an auditory alarm that competes with other sounds in the operating room.

"Electrical engineers are experts at detecting and interpreting signals and, in this way, machines and human beings are the same," says Dr. Dumont. "Signals sent by the brain are weaker and more complex, but we can use the same techniques to process them and provide information for the anesthesiologist."

Drs. Ansermino and Dumont credit a close-knit culture between both research teams with the development of the IAN.

"One of my goals as a teacher is to promote the idea of a clinical researcher—a doctor who brings clinical experience to creating research questions and who also understands how to integrate research into everyday work," says Dr. Ansermino.

"Very often, bioengineering takes place in a lab. For my students, the operating room is the lab," says Dr. Dumont. "As engineers, we are working very close to the clinical practice."

The two are now working to develop innovative, low-cost technologies to improve patient care and safety in the developing world. Instead of producing medical products that serve only a tiny fraction of the world's population—the affluent minority—they are determined to reap broad health benefits for "the other 90 percent."

"Receiving anesthesia during a procedure in Canada is already extremely safe, so it is difficult to show how a new technology could be any safer," says Dr. Ansermino. "It is in the developing world where our technology will make a measureable difference and that will lead to global adoption of our inventions."