software-news domino light 1.5 · 2018. 3. 2. · window and not ecg1. the automatic analysis of...

www.somnomedics.de 1January 2018

Software-News DOMINO light 1.5.0

The latest version 1.5.0 of the DOMINO light software comes with a variety of high quality and user-friendly features specifi cally for the SOMNOwatch™ andSOMNOtouch™ devices

Attention: SOMNOtouchTM devices using this new version of the DOMINO light soft-ware (1.5.0) should also install fi rmware version FW 67 of 02.01.2018 or abo-ve. Please be aware of the following points - as the update also initializes an automatic update. SOMNOtouch fi rmware older than FW60 (6th May 2013): As soon as you transfer a diagnosis from device to PC, you will be automati-cally prompted to update the fi rmware to the new version (FW 2018-01-02). All the data will be saved as it will be automatically transferred with the new software before the fi rmware update.

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January 2018


Software stability improvements for future Product development projects.

Improved Intelligent connect functionality for sensors from the same family.

Better SOMNOtouch Bluetooth transmission stability.

Support of the new sensors for the SOMNOtouchTM RESP and NIBP (see chapter 2)

Prerequisite for the hardware-based software activation with new SOMNOtouch™ devices (see chapter 5)

DOMINO light 1.5.0 should be used with the latest version of the Holter-ECG analysis software Schiller (Medilog Darwin 2 version 2.8.0).

The new fi rmware provides the following improvements:

The raw data channel ECG 2, is now the default channel for analysis purposes. Therefore, this channel is now presented in the software window and not ECG1.

The automatic analysis of arterial fi brillation is now supported by this software version.

The number of preselected stripes in the strip directory was reduced from 4 to 1 to better show the results of the ECG-analysis.

In the strip directory there are now more possibilities for sorting by the length of irregular heartbeats as well as sorting by chronology and degree of severity.

The following points are all new features in the latest version of Schiller:

Content

1. Automatic update of the DOMINO light software and SOMNOtouch™ fi rmware via the internet - P. 4

2. Support of new sensors for the SOMNOtouchTM RESP and NIBP - P. 5

3. Hardware-based soft-ware activation for new installations of DOMINO light - P. 7

4. Creation of an HL7-Inter-face (as an extra purchasable software option) for DOMINO light - P. 8

5. Software option ‘Online Mode’: Displaying signals in real-time for SOMNO-touch™ RESP and NIBP (Item No.: SW005 and SW006) - P. 8

6. Redesign of the fl ow-analysis - P. 9

7. New Functions for the Evaluation of the conti-nuous Blood Pressure determination - P. 11

8. Additional Features - P. 14

9. More features at a glance - P. 17


It is now possible to print user-defi ned areas within the DOMINO light report. Now, every patient can get an individualized report highlighting specifi c measurements.

Examples of all irregular heartbeats can be printed in the DOMINO light report indicating the duration of an event. Stripes for the event type QT are also now available.

The Schiller ECG analysis diagram are now freely selectable from within the report generator of DOMINO light.

After a new installations of DOMINO light 1.5.0, the Holter-ECG analysis software (Schiller Medilog Darwin 2) is now available as a separate software-option (to be changed in the Global Preferences in tab ‘Folders’). So now, activating the ECG analysis with a temporary demo code, is possible.

Below is the list of improvements in the standardized ECG-report in DOMINO light 1.5.0:


1. Automatic update of the DOMINO light software and SOMNOtouch™ fi rmware via the internet

Background:

Up until today, there has been no reliable way to notify users that new fi rmware and software updates for SOMNOtouch RESP and NIBP are available. Which often means users do not have the advantage of many new features and benefi ts.

Features:

With the introduction of the DOMINO light software version 1.5.0 new software updates are automatically detected via the internet. A popup-window informs the user that a new update is available. The user can download the update clicking the link to the password-protected download area of the SOMNOmedics home-page. The next Domino light update (1.6.0) will be only done via this automated pro-cess. The update will then take place in the background.

After you have docked a SOMNOtouch with an old fi rmware version and transfe-red the data, a pop up will appear with the option of updating to the newest fi rm-ware version (if an Internet connection is available).

Benefi t:

User will benefi t from the very latest of updates, allowing SOMNOmedics to continue to off er market leading software and respond even faster to user requests and feedback. Support of new sensors for SOMNOtouchTM RESP and NIBP.

Information:

The previous version can easily be restored (“Restore last version”), if the software-update fails.


2. Support of new sensors for the SOMNOtouchTM RESP and NIBP

4-channel analogue Optocoupler (Item No.: TOS121)

Using the 4-channel analogue Optocoupler is an easy way to integrate exter-nal devices into the DOMINO light software. It enables simultaneous recor-ding of up to four analogue devices or up to four analogue output signals of one external device. Before connecting an external device via the 4-channel analogue optocoupler, the type of the plug and the contact assignment of the plug, output voltage, measuring range and required frequency range are required.

Information:

Please note that your SOMNOtouch™ device needs to have SOMNO-touch™ FW 67 or later recent in order to use these sensors.

Eff ort + 2 PLM + 1-channel ECG Combi Sensor (Item No.: TOS175)

This combi sensor is meant to enhance the ambulatory cardiorespiratory screenings with an eff ort sensor, two PLM and a one-channel ECG sensor. It allows the measurement of the abdominal breathing eff ort, the recording of leg movements with two PLM-sensors (EMG at the right and left M. tibialis), as well as the measurement of the heart activity with a one-channel ECG-sensor. Therefore, it is possible to determine the single or combined respira-tory eff ort, to diagnose PLMD and RLS, to perform ECG diagnostics and to measure the blood pressure in a continuous and non-reactive way using the pulse-transit-time (PTT) method. The simultaneous recording enables the evaluation of possible correlations between measured parameters.

RIP + Thermistor Combi Sensor (Item No.: TOS190, TOS191, TOS192) for the SOMNOtouchTM RESP

The RIP Thermistor combi sensor allows the measurement of the thoracic and abdominal RIP eff ort and the oronasal breathing fl ow with the SOMNO-touchTM RESP at the same time. With a detachable Thermistor the nasal/oral fl ow is determined. The Thermistor is available in diff erent sizes for adults and paediatrics. It is also possible to measure only the thoracic and the abdo-minal breathing eff ort when the Thermistor is not connected to the combi sensor.

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PT + Pressure Combi Sensor (Item No.: TOS200, TOS201) for the SOMNOtouchTM RESP

The current diff erential pressure sensor (Item No.: TOS150) only allows the determination of the diff erential pressure. To record the PAP pressure simul-taneously an additional connection between the mask and the SOMNOtouch™ device has to be established using a silicon tube. To simplify the recording method, the new PT + Pressure combi sensor measures the absolute pressure of the therapy device and the diff erential pressure through the miniaturized pneumotachograph all at the same time. With this technique, the analysis of breathing volume and the determination of leakage while using a CPAP/Bi-PAP-device are more comfortable. The combi sensor is connected directly to the pneumotachograph, what makes the use of the double silicon tube unne-cessary. In this way, follow-up costs are minimized.

3-channel ECG + Intercostal EMG Combi Sensor (Item No.: TOS015) for SOMNOtouch™ NIBP and 1-channel ECG + IC-EMG Sensor (Item No.: TOS016) for SOMNOtouch™ RESP

The intercostal muscle activity is directly measured with the new IC-EMG sen-sors. It off ers a good way to diff erentiate between central and obstructive Apnoea. A very clear IC-eff ort signal results from an IC-EMG signal through a special algorithm and fi lters. It is comparable to the abdominal and thoracic eff ort signal.

Benefi t:

A backup for the abdominal breathing eff ort measured through the eff ort belt.

Integration of Home Sleep Camera (Item no.: VID98) revision C and D

The Home Sleep Camera has already been integrated into the DOMINO light version 1.4.0. It allows cardiorespiratory screenings with the SOMNOtouchTM RESP in a home environment. With the release of the new software, the function has been simplifi ed. Now, the video fi le will be imported when transferring the associated patients data. There is now no need any more to import the video manually after opening the patients data.


Bruxism Sensor (Item No.: TOS210) for SOMNOtouchTM RESP

The bruxism sensor uses a one-channel EMG source on the M. masseter for the detection of bruxism. For the data processing, the analysis and the required add-ons for the report are implemented.

3. Hardware-based software activation for new installati-ons of DOMINO light

Background:

Every new SOMNOtouchTM device comes with two software licences, which al-lows a self-activation of the software by the user. Until now an activation of the software was only possible by contacting the SOMNOmedics service department.

Feature:

Two software licences are saved automatically on new SOMNOtouchTM devices with fi rmware versions 67. The available number of licences is shown next to the SOMNOmedics logo in the fi rmware menu of the SOMNOtouch.This allows the activation of the software, if this device is connected to a DOMINO light 1.5.0 version without a software-activation-key and the virtual docking stati-on on the PC is opened:

The confi rmation with ‘Yes’ is required to activate the DOMINO light installation. The automatically generated activation code will be saved in the Global Preferen-ces. Subsequently, one of the licences on the SOMNOtouchTM device is deduc-ted. After the activation is fi nished, the available licences on the device should be reduced by one (e.g. shown as L:1). This can be checked on the logo-screen on the SOMNOtouch fi rmware:Another activation of a software licence can be done in the same way.

Benefi t:

The hardware-based software activation of DOMINO light easily enables an activation of the software. It is still possible to contact the SOMNOmedics Service department. To activate special options (for example Schiller ECG-Analysis) it’s still necessary to contact the SOMNOmedics service.


Benefi t:

This new software option enables the comfortable signal control and bio calibration without interacting with the SOMNOtouchTM RESP and NIBP display. Therefore, the privacy of the patient maintained.

4. Creation of an HL7-Interface (as an extra purchasable software option) for DOMINO light

Background:

SOMNOtouchTM is frequently used in hospitals requiring a transfer of patient data and measurement values between DOMINO light and the hospital informa-tion system (HIS).

Features:

The new software version DOMINO light 1.5.0 has the possibilities now to set up a standardized HL7 interface (Item No.: OPT260). On the one side, it gives the opportunity to initialise a recording using the patient data from HIS. On the other side, it allows the patient related export of pdf-reports and/or fi ndings in txt fi les to HIS.

Furthermore, a button has been integrated to export marked graphics from the report into the HL7-export folder as MDM fi les.

5. Software option ‘Online Mode’: Displaying signals in real-time for SOMNOtouch™ RESP and NIBP (Item No.: SW005 and SW006)

Background:

The progress of the raw data can be checked in real time on the coloured screen of SOMNOtouchTM RESP and NIBP, while the measurement is running. Also, the SOMNOmedics-BT-App provides the raw data in real time. Although the viewed raw data will not be saved, it can be useful to check the signal quality without disturbing the measurement.

Feature:

Through a password protected Bluetooth-connection the raw data of the SOMNOtouchTM RESP and NIBP devices can be monitored on the screen of a PC or laptop using DOMINO light 1.5.0 version. The additional recording of the raw data is optional. To provide the online mode for DOMINO light 1.5.0 a separate SOMNOmedics USB-Bluetooth-Receiver or an in-tegrated Bluetooth-module on the PC is necessary.

Benefi t:

A time-saving, user-friendly way to exchange data between DOMINO light software and HIS has been established with the implementation of this interface.


6. Redesign of the fl ow-analysis

Extension of the fl ow analysis with an automatic RERA-detection

Initial situation:

AASM leaves it to the physician to report the Respiratory disturbance index (RDI). This parameter is calculated from the sum of apneas, hypopneas and Respiratory Eff ort Related Arousal (RERA) per hour.Up to now, RERA needed to be edited manually as the DOMINO software did not provide an automatic analysis.

Solution:

According to AASM, RERA is a respiratory event, which does not meet the apnea or hypopnea defi nition, but is characterized by an increased respiratory eff ort leading to arousal.DOMINO light 1.5.0 now recognizes such periods of increased respiratory eff ort followed by an arousal and automatically assigns the appropriate RERA.

Benefi t:

Using DOMINO light 1.5.0, either cortical arousal in EEG and EMG channels or autonomic arousal can be selected for the automatic detection of RERA.

RERA with a cortical arousal. The increased breathing eff ort is detected in the thoracic eff ort. The RERA is marked as respiratory event in the Flow channel.

RERA with autonomous araousal. The increased breathing eff ort is detected in the abdominal eff ort. The RERA is marked in the Flow channel as respirato-ry event.


Apnea preferential to Hypopnea

Initial situation:

In many cases the software recognized hypopneas instead of apneas due to the existing rule to take respiratory events which correlated best with the duration of desaturation. According to the AASM Manual, an apnea needs to have a higher priority than hypopnea if a portion of the respiratory event meets the criteria for apnea.

Solution:

Using the checkbox “Apnea preferential to Hypopnea” which has been added to the Flow Analysis of DOMINO light 1.5.0, a respiratory event will be scored as ap-nea if it meets both criteria for hypopnea and apnea.

Additional parameter “Duration Hyperventilation” for automatic Flow Analysis:

The automatic Flow Analysis in DOMINO light 1.5.0 contains the additional parameter “Duration Hyperventilation”. The new parameter defi nes the time period following a respira-tory event that will not be taken into account by the algo-rithm of the fl ow analysis. The reason is, that hyperventila-tions following respiratory events infl uence the calculation of the baseline for Flow Analysis. This leads to incorrect de-tections of hypopneas and apneas.

Benefi t:

The analysis of polygraphy recor-dings is carried out according to the criteria of the AASM Manual.


7. New Functions for the Evaluation of the continuous Blood Pressure determination

Blood pressure report components

The standard BP-report is updated with the new DOMINO light version. The acti-vity level is clearly visible using a system of coloured bars (1). In addition, the cri-teria for artefact classifi cation for blood pressure values has been modifi ed to over 80 percent. Also, the way of displaying blood pressure values is designed to be less vulnerable to artefacts, because a longer timeframe of +/- 10 seconds is taken to now calculate the values.The report component ‘Blood pressure Day/Night (advanced)’ has been redesig-ned. The units are positioned behind the parameter descriptions now (3). The subsection of the Day/Night behaviour can be blanked if necessary (4).Another add-on is the artefact time specifi cation shown in the blood pressure Day/Night report as well as in the conventional BP report (2).

To prevent misunderstandings the two sections RR-interval and stress are com-bined within the HRV part of the report. The section of the RR-Intervals is enlar-ged. It is now possible to decide whether to see the RR-Intervals only, during the TIB, or for the whole measurement.To allow a fi ner division of the blood pressure report, for example at short slee-ping periods, an option has been implemented to reconfi gure the time intervals.


Therefore, it is possible to choose between the standard classifi cation (30 minutes between 10:00 pm and 06:00 am and 15 minutes bet-ween 06:00 am and 10:00 pm) or a 5 minute- and a 10 minute-interval respectively. For the plot in the blood pressure day/night report more options have been implemented. You can choose between 1, 2, 5, 10, 15, 20, 30, 45 or 60 minutes. The default selection is a 30 minute-in-terval at night and a 15 minute-interval during the day.The increases in the heart rate and in the blood pressure during the day will be also considered for blood pressure fl uctuations. In the tab ‘Views’ it is possible to choose interesting events that happened during the day. Furthermore, at the beginning of a pure day time measurement the software sets a ‘Lights On’-marker for easier hand-ling.

Blood pressure calibration

During the calibration for the blood pressure measurement with the PTT-method it is now possible to calibrate down to a diastolic low level of 40 mmHg.The maximuml possible diff erence between the diastolic and systolic amplitudes was 80 mmHg during the blood pressure calibration with the SOT. If this maximum was pushed to its limit, it was possible, that the blood pressure did not appear in the mea-surement display. This was caused by a slightly smaller amplitude maximum in the DOMINO light version 1.4.0. The highest possible software value has been adjusted in keeping with maximum of the fi rmware. If a correct calibration value is present out of the fi rmware, the PTT analysis parameters for the blood pressure calibration will be blocked.In the beginning of a SOMNOtouch RESP measurement a marker with the blood pres-sure values is set, showing the input of the calibration with the blood pressure cuff in advance of the measurement. With DOMINO light 1.5.0 to the entered blood pressu-re values, the time point of calibration is also displayed at the marker.


Additional features regarding blood pressure

The montage for the SOMNOtouch NIBP including the 3-channel ECG sensor with body position (Item No.: TOS015) is now implemented by default.

Also, the correlation between increasing in blood pressure and oxygen desatura-tion has been added. The resulting value will be displayed in the report part NBPF and the PTT in the circle diagram shown in red.


8. Additional Features:

Consideration of body position changes within the Sleep/Wake-Analysis

Diff erentiation between snoring and breath sounds in Snore Analysis

The new parameter “Threshold Breath Sounds” allows to distinguish between snoring and breathing sounds. Breathing sounds will be marked in the analysis channel “Snoring”.

Improvement of ECG-Elimination in the EEG Signal

The ECG-Channel is set by default as a source for the automatic Wavelet-elimina-tion of heartbeats in the EEG in the Global Preferences of DOMINO Light. The re-sults based on a specifi c ECG-channel are better compared to the source “de-fault”. This version of ECG-elimination searches for R-Peaks within the ECG-channel, where they are most obvious and eliminates them in the EEG-chan-nel. Furthermore, the Wavelet-ECG-elimination during extrasystoles has been im-proved.

One screen for most important analysis results when opening a recording without opening the report at the same time

The new view “Results + Analysis View” displays the most important analysis re-sults in an opened recording at a glance. It is no longer necessary to open a re-port. DOMINO light 1.5.0 already contains pre-defi ned templates for the “Results + Analysis View” that can be modifi ed according to the user’s needs.

Set Makers with user-defi ned key combinations

For comfortable handling markers can be set with diff erent key combinations. These key combinations for diff erent mar-kers can be specifi ed in the tab “Markers” of the menu Global Preferences.

Key combination to “Show/Hide” markers

For reasons of clarity all markers can be hidden using a ma-nually-defi ned key combination. This can be specifi ed in the tab “Keys” of the Global Preferences.

Possibility to create generic events with overlap

DOMINO light 1.5.0 allows to draw in overlapping generic events in diff erent raw data channels (source channels).


Changed order of the Auto processing

In order to improve the handling within the sleep laboratory, stages for Autopro-cessing have been adjusted.After fi nishing the measurement, it is possible to archive data directly after analy-zing it.After that, the report can be automatically opened, exported and printed out from the archived fi le. It’s also possible to let the report open after fi nishing the measurement forgoing the archiving.

Defi ning a report template for Auto processing after transfer or the end of an online recording

During Auto processing the checkbox “Report” can be activated. Activation of the checkbox automatically opens the standard report right after the analysis is fi ni-shed without requiring any further user interaction. Alternatively, a specifi c re-port template from the Global Preferences can be chosen.

Easier correction of the duration and placement of events

Events within a signal are marked with coloured event boxes in the raw data win-dow. If placing the mouse cursor over the event box in DOMINO light 1.5.0 a crosshair cursor will be displayed. This enables the user to move the event box along the raw data channel while keeping duration of the event constant. Moreo-ver, arrows are displayed at the beginning and the end of each event box in order to extend or shorten the event duration.

Display self-defi ned raw data- and analysis profi les in Global Preferences with characteristics

Option to delete a video of a measurement

In case the video is not needed but only the measure-ment itself, the user can delete the footage in the Ope-ning Dialoge by a right click on the measurement.

Easy deletion of events during “Jump to next event” with pre-defi ned key combination and Delete-Key

During manual editing of events the key combination “Jump to next event” can be used to jump to the next event within the same raw data channel. This feature was already available but has been extended by the opportunity to delete the selected event with the Delete-Key.


Additional values in the PAP table

So far, all PAP reports contained fi xed report parameters. It was not possible to select report parameter individually.DOMINO light 1.5.0 provides the opportunity to select relevant results in the global and local Report Generator for standard, advanced and user-defi ned PAP reports. Up to 7 parameters can be chosen according to relevant results.These features are implemented to guarantee a user-friendly, intuitive and time-saving operation during PAP therapy titration and control.

Key combination to set “Light Off ” and “Light On”-Markers

DOMINO light 1.5.0 allows setting the “Light Off ” and “Light On”-Markers to specify the TIB with a key combination. The key combinations can be specifi ed individually in the tab “Markers” of the menu Global Preferences.

Export for analyses data to Excel

With the new software DOMINO light 1.5.0 it is possible to export data for further analysis (e.g. for statistical evaluation). All analysis data are exported to a single Excel fi le with a separate spreadsheet for each analysis channel. The user can choose whether to export the whole measurement or just a part of it.

17

9. More features at a glance

Searchable option for the hardware-ID has been added to the opening dialogue

Additional column ‘results’ in the opening dialogue regarding AHI (more details available if mouseover)

The column has been implemented to make a look at the analysis results possib-le without opening the measurement. Up to three diff erent parameters can be chosen.Hier Bild: 31_results_in_the_opening_dialogue.pngIf only one parameter has been chosen, it is possible to sort the measurements by this parameter.

Implementation of the feature ‘fast view’ into the opening dialogue

It is a very interesting view - where the user cannot adjust settings or set any events. However, its far quicker than opening a measurement in ‚normal mode‘.

Colour for epoch markers

When choosing a time window longer than 30 secs the beginning and the end of each epoch (30 sec raw data window) are marked with an epoch marker (grey, vertical lines) by default. In order to improve the visibility of these epoch markers an alternative “Colour for Epoch marker” can be chosen in the tab “Display” of the Global Preferences.

Direct export of recordings to SOMNOmedics Database Program without opening the recording

Authentication of User Manager via LDAP protocol allows to change the current (Windows ) user without interruption of ongoing recordings

Adaption of the diagnostics list to ICSD-3

Additional software option to import analysis channels in txt-form into DOMINO light measurements (Item No.: SW004)

… and many more

SOMNOmedics GmbH | Am Sonnenstuhl 63 | 97236 Randersacker Tel: +49 (0) 931 3590940 | [email protected] | www.somnomedics.de

Information:

The functionality of the DOMINO light software 1.5.0 has been tested with the following operating systems: Windows 7 Professional /32/64 Bit), Windows 8/8.1 (32/64 Bit) and Windows 10.

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