Rina Rabarimanantsoa was born in 1983. She received a Bachelor degree in 2000. From 2000 to 2002, she was studying Mathmatics and Informatics Applications. She obtained general studies diploma (DEUG) in june 2002. Subsequently, she was studying Biomedical Sciences until 2005. As the result of this work, she received an engineer diploma in Biomedical Sciences from the University of Besançon (ISIFC). From November 2004 to August 2005, she was doing a working experience on the production of catheters in Arthesys Company France).
In October 2005, she was selected for a Ph’D thesis (supported by ADIR Assistance) on the following subject : Synchronization in mechanical ventilation with patients presenting chronic respiratory failure. In 2007, Herinaina was awarded by the European Respiratory Scciety. This award was supported by ResMed Limited. This work was performed in collaboration with J.-F. Muir’s team (GRHV EA 3830). She defended her Ph’D thesis on December 2, 2008. She is now BIO-Medical Engineer in Research & Development for Medtronic Galway.
Non invasive ventilation (NIV) is an usual and efficient treatment to relieve hypercapnic respiratory failure. A ventilator is connected to patient’s face through a mask and insufflates some air into the respiratory airways. However, the success of NIV mainly depends on blood gases normalisation as well as on a good synchronisation between patient’s inspiratory efforts and ventilator’s responses. The ventilator must trigger or be adequately stop the pressurisation according to patient’s inspiration or expiration. Furthermore, since patients are mostly ventilated during their sleep, the main objective of this thesis was to characterize and to quantify patient-ventilator interactions during sleep. For that purpose, techniques borrowed from non linear dynamic systems theory (phase portrait, Shannon entropy, symbolic dynamics) and from statistics (distributions, Markov matrix) were developed and validated in order to objectively appreciate the quality of patient-ventilator interactions during sleep and to evaluate their consequences on sleep quality and efficiency. From a clinical study including forty one patients with respiratory failure, patient-ventilator interactions were found non optimal in about half of patients who also present major leaks. A privileged relation was found between asynchronies and the presence of micro-arousals and awakenings. These results prove that asynchronies contribute to sleep disruption.
This thesis was supported by ADIR Association