| Summary: | 碩士 === 元智大學 === 機械工程學系 === 97 === Autonomic dysfunction syndrome (ADS) is reported in 15-33% of cases after severe traumatic brain injury (TBI). The clinical manifestations consist of fever, tachycardia, hypertension, tachypnea, dystonia, diaphoresis, increased intracranial pressure (IICP), etc. The vulnerable injured brain is easy to suffer from the secondary injury resulting from ADS in the acute stage. Increased morbidity and mortality are usually associated. Timely clinical assessment and fine critical care are crucial to the prognosis, and this should be proceeded aggressively under careful monitoring.
By joining the engineering technique and clinical medical care system together, this study is aimed to establish an autonomic nerval monitoring system based on the currently-used monitoring in the intensive care unit (ICU) for TBI patients. In this study, we choose the electrocardiogram, and apply the analytic algorithms of detrended fluctuation analysis (DFA) in heart rate variability analysis (HRV). With the characteristic of fractal and self-similarity, the activity of the autonomic nervous system could be assessed.
In order to help to test and establish the index of autonomic nervous system (ANS), we apply the data recorded from normal subjects to investigate the ANS activity with different influence of external stimulations on the beginning stage of this study. On the second stage of this study, we further choose the severe TBI patients who are under heavy coma and lose the function of ANS as material for this investigation, and assess the activity of ANS along the treatment course for the severe TBI patients via the ANS index. Moreover, we observe the relationship between the activity of ANS and clinical condition. By the information derived in this study, we wish to predict prognosis and monitor the patients’ response to the therapeutic intervention. Finally, we hope this monitoring system would deliver the information to guide the clinicians to predict outcome and make treatment plan for the clinical care. Therefore, the patients’ safety and the quality of clinical cares are enhanced.
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