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Adult ECMO Simulator

Can I alter the weight of the patient?
In this version of the program the weight of the patient is fixed at 75 Kgs although the supervisor is able to vary the patient's nominal oxygen utilisation in the range ~1 - 5 mls/kg/min. The parameters of the underlying models are generally indexed to body weight and are appropriate for adults in the range 20 - 100 kgs. However, it should be noted that some parameters (such as FRC and other lung volumes) are defined in absolute values and will not change if body weight is altered. The pharmacokinetic parameters have been modelled using data obtained from adults.

Can I run it on a MAC?
The application has been successfully tested on a Mac pro system running 'Windows 7' under 'Parallels Desktop 7 for Mac'.

Can I run it under 'Windows 8'?
The application runs under both the 'Developer' and 'Consumer' versions of Windows 8.

How do I move one of the main windows?
If you want to move the 'Patient Monitor', 'Inspector' or 'Therapeutic Interface' window:
Place the mouse at the top right-hand corner of the window and Drag it while holding down the left mouse button. The position of the window will be retained when you next start the application.

What's the difference between loading a 'Patient' and loading a 'Scenario' on the 'Tools' menu?
If you load a 'Patient', you will load a patient's nominal physiological state, but all other components of the current scenario (notes, investigations and resources) will remain unchanged.
If you load a 'Scenario', you will load the patient who is represented in that scenario together with the notes, investigations and resources which are associated with the selected scenario.

Can I run the system using a direct ethernet connection between two computers?
Yes you can. For advice on how to set up such a connection, see, for example,

Can I run the system under 'Windows 7' operating system?
The application runs under the 32 and 64-bit versions of 'Windows 7 Ultimate' ('Release to Manufacturers' version).

How do I install the Supervisor Application on another computer?
Copy the file 'MSESupervisor.exe' from the installation directory to the computer of your choice. No other files are needed. Refer to the manual section entitled 'System Requirements' for a description of the hard- and soft-ware requirements of the supervisory device.

Can I run the Main Application and the Supervisor Application on the same computer?
Yes you can, but the screen may become rather crowded (unless you have a 2560 * 1600 display).

How, (as Supervisor) can I make the patient hypoxic?
Two techniques are available:
Progressively increase the 'QsQt' value on the 'Lung' page of the Supervisor Application.
Administer a hypoxic mixture using the 'FiO2' control. However, it should be noted that it is not possible to administer a hypoxic mixture to the patient if the ventilator is turned on.

How, (as Supervisor) can I make a spontaneously breathing patient hypercarbic?
Progressively increase the 'CO2 SP' value on the 'Misc' page of the Supervisor Application.

How, (as Supervisor) can I make a ventilated patient hypercarbic?
Progressively increase the 'VdVt' value on the 'Lung' page of the Supervisor Application.

How, (as Supervisor) can I make the patient hypotensive?
Either slowly reduce the SVR, or slowly reduce the CI on the page of the Supervisor Application.

Is there a drug database editor?
No. At the present time, it is not possible to add new drugs to the system.

Can I run the system using a dual display?
Yes, the system has been tested on conventional dual -display (second monitor) systems as well as remote dual display systems such as 'Maxivista'.

How, (as Supervisor) can I change the patient ('pat') file which is associated with a scenario?
  • Start the Main Application in 'Maintenance Mode'.
  • Click 'System''Scenario Editor'.
  • Navigate to the 'ScenarioData' folder by clicking the appropriate '+' signs in the 'Folder Navigator' folder tree
  • Click on the database file 'MSEScenario.mdb'.
  • Right Mouse Button click this file to load it into the 'Database Editor' window.
  • Click on the folder of the Scenario whose patient file you wish to change.
  • Click 'Edit' in the pane which appears.
  • Select the 'Pat' file which you want to use from the 'Folder Navigator' window. (This file name should be transferred into the 'File Name' field of the editor pane).
  • Click the 'Save' button.
  • Click 'Save and Exit'.
  • Click 'System''Exit'.

Do the alarms work on the physiological monitor?
No (Not yet).

If I don't heparinise the patient, will the oxygenator clot?
It will not do this automatically. However, the supervisor may choose to fail the oxygenator if you do not heparinise the patient in a 'supervised' session.

Why do many of the tutorials advocate paralysing and ventilating the patient?
The patient has a considerable amount of innate respiratory behaviour. If ventilation is not controlled, it makes it harder for the trainee to identify the effects of the various manoeuvres which are being performed.

Why do the PaO2 and SaO2 rise transiently if I initiate ECMO without any fresh gas flow?
 The oxygenator is assumed to have been flushed with oxygen before use. The transient rise represents oxygen delivery from the shell ("Functional Residual Capacity") of the oxygenator.