Chapters Transcript Video Esophageal Manometry Analysis using GIM-6000E This tutorial will describe how to open an acquired study in the BioVIEW® Software, open a measurement and analyze the data, and generate the report. four Channel Express Asafa Geo Manama Tree Analysis. This tutorial will review editing of studies acquired using either a clinical innovations Air charged or a Kononsberg Solid state catheter. Upon completion of this tutorial, the participant will be able to describe how toe open an acquired study. In analysis, view. Describe how toe open a measurement and analyze the data. Generate a report after reviewing the findings. First, we'll review the bio view icons. The icons on the toolbar are grouped according to their purpose. Application. Icons include the ability to open additional studies from the folder icon, save, edited and changes or undo a change or redo a change or to print. The navigation icons will make it easier to move forward or back on the tracing, either one page at a time or from event to event or measurement to measurement. The study. Viewing icons allow you to magnify an area of study on either the X or Y axis or both, or to quickly return to your um, magnified view. The time range box will be used to open the study in smaller segments. The editing icons provide you with tools such as the Analysis tool, which when activated will display the measurement points and results. With these tools, you can create additional events or measurements in your study. Yeah, the display icons provide different ways to view the study, such as utilizing Sink View, which provides a graphic display of the pressure activity over a selected area. In addition to the toolbar icons, the View menu offers different methods to view the screen. Analyze will allow the user to turn on the Elektronik ruler to measure way forms and data points manually, or have the computer analyze either all measurements or any measurement selected by the user as in analyze selected measurement. If using the analyze, all measurements be used with caution as any user directed editing will be lost and the measurements will be re analyzed by the computer set. The default marks allows the user to set the analysis marks if needed, and the unset and end marks or vertical lines, and the amplitude or real action marker. The X will need to be manually edited by the user view. The data table opens the data spreadsheet of all calculated values for each study section. The report tab allows you to create the report If no previous report has been created, this will be the only option available. A new report should also be created. If there's any changes in the editing of study, the View Edit report option will be available. If a report already exists, use this option. If you need to edit any of the patient information on the report. The View Edit report function will not re calculate any values based on editing changes. Delete Report is also available. If you choose to delete the current report, open the study and the analysis software by selecting either the bio view analysis icon or the analysis icon. Depending on your software version, double click on the sandhill application's icon on the desktop. Double click on bio View analysis, then click on the file in the top left of the screen. The patient file is found in the following pathway. See Dr Backslash sandhill backslash patients. Backslash, esophageal. The study will open on the screen in a compressed view. The Ranger scale for each way form can be adjusted to keep the way form within its own box. By lowering the range, it will make it easier to see minor pressure changes here we see the entire study displayed on the screen. You can spread the screen out to a two minute window by clicking on the time range box. In this compressed view, a general impression can often be made from the display. At the beginning of the study, the first measurement box that you will encounter will be the gastric baseline. If necessary, adjust the baseline measurements of the way form rests on the X scale by pulling the zero axis line up to the way form. Move your white arrow cursor until it changes to a black line with a double black arrow, then click and drag the X axis to the bottom of the way form and release. This will change. Put the way form on the X axis and essentially zero. The pressure. This slide demonstrates the changed gastric baseline. Next, we will profile the LDS by placing the following markers the distal marking the gastric edge of the sphincter pip or pressure inversion point, where the sensor crosses from the abdominal cavity to the thoracic cavity and the proximal edge or the Asafa geo body edge of the sphincter. Start by locating the distal border of the L ES in Channel four. This will be found at the point where the way form rises off the X axis and stays elevated. Move the cursor to where you want to mark this location. Click on the create event icon and then named the event distal. The flashing line should appear in the probe depth area where you want to identify the distal edge. Be sure when you open the create event window that the probe channel that is being recorded is the correct one. Distal will be noted at the top of the event line. The event could be placed anywhere between the probe depth lines. Next, you will identify the pressure inversion point where the respiratory deflections change from increasing with respiration to decreasing with respiration. Lastly, we will note the proximal edge of the L es or the point where the sphincter pressure drops off to below baseline. Locate the pressure inversion point and right click. To get the flashing event line, repeat the create event process. As for the distal marker, then move along in the study and find the proximal edge of the L. E s. This is where the pressure drops to baseline or below, indicating that you've entered that sensor into the thoracic cavity. Next, you will scroll to the L. E s resting Pressure measurement Scroll to the resting pressure measurement. Activate the measurement box by right clicking in the box. This will put a broken box around it, Then click the analysis tool in the toolbar to review the results. With the analysis tool activated, the results for the active measurement will display to the left side of your screen. In this measurement, the residual marker has been placed in a respiratory dip. This is incorrect, and the ex markers should be moved. To adjust the analysis mark, place the cursor on the mark, which needs to be moved, and wait for it to change to a plus sign. Then it could be dragged to a new area. Click and drag left, click and drag to the correct location and release the mouse button hit. The residual marker has been moved to the lowest point of relaxation that was not part of a respiratory dip. Next, activate the contraction measurement in the body of the esophagus to move a marker line, hover the cursor over the line until the cursor changes to a double arrow to marker, then left click and drag the vertical marker to its new position. The start of the contraction should be at the upstroke of the contraction, and the peak is at the highest point. The end of the contraction is where the way form comes back to baseline. This example shows the corrected position for the vertical marker. Continue analyzing each remaining measurement in the lower body study. Periodically click on the save button on the upper left hand side of the toolbar to save your changes. After completing the lower body measurements, proceed to the upper body measurements taken in Channel two. If needed. Adjust any contraction markers in these measurements. At this time, you may choose to print portions of the study. If this is desired, click on the printer icon on the toolbar. Select the strip chart tab, select all and then add minutes per page. While the study is printing, you could go back and select the measurement tab, then select all and thumbnails to print out the measurements with analysis marks for your records. The U. S study After completing your review of the L ES and lower body and upper body measurements. Go to the procedure bar at the top of your screen, click on the drop down menu and select the U. S. Study. The entire U. S study will be displayed. The access magnifier could be used to magnify the U. S profile section of the study or change the timeframe to a 32nd window. With the pressure profile section expanded, it will be easier to identify the high pressure area. Next. You will create the measurements in this area of the study by clicking and dragging across the desired area. Then click on create measurement icon and select the type of measurement that is desired. When you click and drag the cursor across an area green box will appear. Click on the Create a measurement icon in the toolbar at the top of your screen in the creative measurement box. Be sure USPS selected for the measurement type and that Channel two is identified as the U. S Channel. The completed measurement box will then turn yellow. Next, you will create a fair and deal baseline measurement. This is usually created just above the U. S. Pressure measurement. After drawing a green box click on the Create a measurement icon again, make sure the measurement type ISS Fair in Jail baseline and that Channel one is labeled labeled fair Knicks. Click on the View Entire Procedure Icon on the toolbar To return to your unmanned ified screen, click on the Axis magnifier to magnify the swallow area. Identify the what's follows that were given during the acquisition. Click and drag a green box across the swallow to include both channels. Then click on the Create measurement icon on the toolbar. The green box will go away in a new window. Will open name this measurement US coordination. Create additional U. S. Coordination measurements in this fashion. After all the measurements are created, used the access magnifying tool to magnify the individual measurements. Click on the analysis icon to to see the markers for the measurement. The fair in jail contractions will be analyzed the same as a soft Jill body contraction and the US relaxation is analyzed, indicating the beginning of the relaxation and the end of the relaxation. Along with the residual pressure check that the contraction started correctly marked by moving the vertical marker as needed. This slide shows the correctly marked contraction. If a printed strip of the measurement is desired, you may now select 3 to 5 representative samples. Click on the printer icon on the toolbar select screen, then fit to page to print your representative samples. Next, if desired, you can print thumbnail measurements that will show marks in the measurement and patient results. Select all and thumbnails in the top of the print window, then select fit to page. Now it's time to create the report. Click on the report in the toolbar and select Create report From the drop down menu. Use the template with the appropriate hospital or clinic name. Typically, this is the standard report to which your hospital information has been added. Make sure any portions of the study that you want to report are activated with a check mark in front of the study name. Standard template will be the default report selection. Review the report making any changes as desired on the front page. You may want to add the patient's symptoms and medications scroll through the study reviewing the results. Any abnormal patient results will be bold and underlined if any of the patient results appear to be incorrect, go back to the measurements and review them individually again. The report could be edited the same as any word document. Print a report by clicking on the print icon on the toolbar. Patient files could be downloaded onto any portable device. Following these steps, click on the word file in the tool bar, then select export patient from the drop down list. When the export window opens, you will select the proper drive for saving a copy of the study. At this time, you may choose to de identify your patient. If this option is selected, another window will then open, allowing you to change any patient information you wish to de identify before trans exporting. When done with the export, printing or report creation. Closed your study By clicking on the X in the upper right hand corner of your screen, you will be prompted to save your changes. If you have not done so, However periodically during the analysis period, you can click on the Safe Icon, which appears as a disk in the upper left hand corner of the toolbar Created by
