A decision support system for suggesting ventilator settings: retrospective evaluation in cardiac surgery patients ventilated in the ICU

Computer Methods and Programs in Biomedicine
Charlotte AllerødS Andreassen

Abstract

Selecting appropriate ventilator settings decreases the risk of ventilator-induced lung injury. A decision support system (DSS) has been developed based on physiological models, which can advise on setting of tidal volume (Vt), respiratory frequency (f) and fraction of inspired oxygen (FiO2). The aim of this study is to assess the feasibility of the DSS by comparing its advice with the values used in clinical practice. Data from 20 patients following uncomplicated coronary artery bypass grafting (CABG) with cardiopulmonary bypass was used to test the DSS. Ventilator settings suggested by the DSS were compared to the settings selected by the clinician. When compared to the clinician the DSS suggested: lowering FiO2 (by median 7%, range 2-17%) at high SpO2 and increasing FiO2 (by median 2%, range 1-5%) at low SpO2; lowering ventilation volume (by median 0.57 l min(-1), range 0.2-1.1 l min(-1)) at high pHa and increasing ventilation volume (by median 0.4 l min(-1), range 0.1-0.9 l min(-1)) at low pHa. Suggested changes in ventilation volume were such that simulated values of PIP were < or = 22.9 cmH2O and respiratory frequency < or = 18 breaths min(-1). In all cases, computer suggested values of FiO2, Vt or f were consistent with ...Continue Reading

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References

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Oct 31, 2001·Intensive Care Medicine·A Van de LouwL Brochard
Jul 10, 2002·Journal of Clinical Monitoring and Computing·Stephen Edward ReesSteen Andreassen
Apr 17, 2003·Intensive Care Medicine·Søren KjaergaardSteen Andreassen
Apr 19, 2005·Critical Reviews in Biomedical Engineering·S E Rees, S Andreassen
Oct 19, 2005·Intensive Care Medicine·Lorraine N Tremblay, Arthur S Slutsky
Jul 15, 2006·American Journal of Respiratory and Critical Care Medicine·Francçois LelloucheLaurent Brochard
Sep 16, 2006·Journal of Clinical Monitoring and Computing·S E ReesS Andreassen

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Citations

Sep 16, 2006·Journal of Clinical Monitoring and Computing·S E ReesS Andreassen
Nov 23, 2011·Medical & Biological Engineering & Computing·Dan S KarbingStephen E Rees
Jan 15, 2014·BMC Medical Informatics and Decision Making·Fatma Patlar AkbulutB Siddik Yarman
Apr 2, 2011·Journal of Critical Care·Charlotte AllerødStephen E Rees
Sep 14, 2015·Computer Methods and Programs in Biomedicine·Jarosław GlapińskiAdam G Polak
Feb 21, 2014·Critical Care : the Official Journal of the Critical Care Forum·Kaouther SaihiLaurent Brochard
Sep 18, 2018·Anesthesia and Analgesia·Maximilian S SchaeferTanja Astrid Meyer-Treschan

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