Technology and Engineering in Anesthesia and Critical Care
Anesthesiology and critical care are technology-intensive medical disciplines that have enjoyed significant and measurable improvements in patient care over the last several decades. Technologies such as gas analyzers, arterial pulse oximeters, electronic infusion pumps, advanced airway devices, portable ultrasound, and echocardiographic imaging have reduced the mortality directly attributable to anesthesia.
This reduction has been pronounced. Anesthesia is specifically mentioned as an exemplary medical subspecialty in the 2000 Institute of Medicine book “To Err Is Human: Building a Safer Health System:”
“Anesthesiology is an example of a local, but complex, high-risk, dynamic patient care system in which there has been notably reduced error. Responding to rising malpractice premiums in the mid-1980s, anesthesiologists confronted the safety issues presented by the need for continuing vigilance during long operations but punctuated by the need for rapid problem evaluation and action. They were faced with a heterogeneity of design in anesthesia devices; fatigue and sleep deprivation; and competing institutional, professional, and patient care priorities. By a combination of technological advances (most notably the pulse oximeter), standardization of equipment, and changes in training, they were able to bring about major, sustained, widespread reduction in morbidity and mortality attributable to the administration of anesthesia.” (p. 164)
As attributable mortality has fallen, anesthesiologists and surgical intensivists have shifted their focus from catastrophic intraoperative events (such as equipment failure and unanticipated difficult airway) to poorly understood, important perioperative considerations that appear to impact long term morbidity and mortality. This shift of focus, from the immediate operating room environment to the broader perioperative experience, offers the anesthesia and critical care communities a second opportunity to improve patient care.
The University of Virginia Department of Anesthesiology has a strong interest in translational research and biomedical engineering and is well equipped to make a meaningful contribution to this “second wave” of patient care improvement in the perioperative period.
The mission of our translational/engineering effort is threefold:
- Offer the biomedical device community the opportunity to validate their technology safely, in the setting of a major academic medical center, using the highest ethical and scientific standards
- Develop technology designed to lower the morbidity and mortality of the surgical and critical care patient populations
- Strengthen the bond between the School of Engineering and Applied Science and the School of Medicine at the University of Virginia
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