| Background: The mobile interventional treatment cabin is a new piece of medical equipment developed by our study team, aimed at providing rapid interventional treatment of cardiovascular disease following natural disasters and filed war. The cabin was used in disaster-stricken areas in order to increase the ability of emergency treatment for patients with Acute Myocardial Infartion(AMI), which is essential for early diagnosis and therapy of critical cardiovascular disease.We aimed to develop a Mini Mobile Cabin to provide emergency interventional services for patients with coronary heart disease following naturadisasters and filedwar.However, as the first cabin in our country, the x-ray radiation doses level, image quality, cleanliness in cabins are still needs to be further study and investigate. In addition, the feasibility of using field shelter to provide Percutaneous Coronary Intervention(PCI) for patients with Coronary Heart Disease(CHD) were also needed to be investigate. the present study aimed to further study the questions above.Objective: The aim of the present study is to evaluate the safety of radiation doses, image quality, cleanliness of the cabin systemically. And investigate the feasibility of using field shelter to provide PCI for patients with CHD following natural disasters.Methods:1. Speciman:(1) The experimental animals included six pigs, which were purchased by experimental animal centre.(2) Novel miniature mobile cardiac catheterization laboratory.(All the equipment was designed by our study team)2. the evaluation of image quality in cabins:We implemented coronary angiography on six experimental animals with nine different projection positions, observe and compere image quality of different projection position.3.the investigation of X- radiation dose to patients:(1) Comparison of image quality and radiation dose between field shelter and catheterization room during intervention therapy: dose-area product(DAP) influoroscopy and digital acquisition are measured with standard phantom in field shelter and cardiac catheterization room respectively.(2)Protection evaluation of X-ray radiation: The radiation dose detectors were used to evaluate the abdominal radiation dose rate when the surgical personnel were next to the c-arm X-ray machine with or without lead shade protection etc.4. Cleanliness evaluation of field shelter:According to the nursing conventional and the disinfection technical specifications, sampling immediately after sterilization and dropping following disinfection technical specifications. Then opening samples in the 9cm-diameter ordinary agar plate, testing immediately after 5 minutes exposure. Lastly, counting the number of bacterial colonies per liter in air after setting plate in 37 ℃ tablet within48 h.5. Feasibility of intervention treatment for CHD in cabins:The Cabins was transported to remote communities by truck( lingyuan and xiuyan respectively), providing emergency treatment for native patients with critical coronary heart disease, then we compared the patient with CHD with the ones in conduit room at the same time.Results:1. Image quality of coronary angiography between Field Shelter and cardiac catheterization room group were no statistically significant difference:The image quality in field intervention cabin was similar with which obtained incardiac catheterization lab. Angiographic results showed a qualified image in field intervention cabin except left shoulder shows and spleen shows. Clearly images of blood vessels and good contrast ratio were obtained in field intervention cabin.2. The X- radiation dose to patients during interventional therapy:(1) The dose of field shelter group between the cabins and cardiac catheterization room group were statistically significant difference. The DAP valve of field shelter in fluoroscopy is above the cardiac catheterization room group. However, the DAP valve of cardiac catheterization lab in digital acquisition is above the field intervention cabin.(2) When C-arm X-ray machine was used, abdominal radiation dose rate increased without the protection of radiation in teach area.The radiation safety in the square cabinet c-arm X-ray machine is up to standard with the protection.3. Cleanliness assessment of field shelter:Field intervention cabin unfolded in different environments with a better condition, cabin’s equipment is in good working condition and staff felt comfortable.Checking the number of bacterial colonies under different conditions, the sterilization effect is good, the average total number of bacteria after disinfection is within the qualified range.4. Feasibility of intervention treatment for CHD in cabins:There were 17 patients being performed immediate interventional treatment.Nine patients only being performed angiography, and 8 patients underwent implantation of bare-metal stent. The operation is successful and no complications. In clinical application, local patients with critical cardiovascular disease achieved 100% survivalrates. SCA procedure took 17-34(26±6) minutes, PCI procedure took 33-51(38±6)minutes. And there are no differences between the two group.Conclusions: The novel miniature mobile cardiac catheterization laboratory could provide the immediate interventional treatment for patients with CHD following natural disasters in prime time, and the process is safe and feasible. |
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