Using physiological models and decision theory for selecting appropriate ventilator settings.

Abstract:

OBJECTIVE:To present a decision support system for optimising mechanical ventilation in patients residing in the intensive care unit. METHODS:Mathematical models of oxygen transport, carbon dioxide transport and lung mechanics are combined with penalty functions describing clinical preference toward the goals and side-effects of mechanical ventilation in a decision theoretic approach. Penalties are quantified for risk of lung barotrauma, acidosis or alkalosis, oxygen toxicity or absorption atelectasis, and hypoxaemia. RESULTS:The system is presented with an example of its use in a post-surgical patient. The mathematical models describe the patient's data, and the system suggests an optimal ventilator strategy in line with clinical practice. CONCLUSIONS:The system illustrates how mathematical models combined with decision theory can aid in the difficult compromises necessary when deciding on ventilator settings.

journal_name

J Clin Monit Comput

authors

Rees SE,Allerød C,Murley D,Zhao Y,Smith BW,Kjaergaard S,Thorgaard P,Andreassen S

doi

10.1007/s10877-006-9049-5

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

421-9

issue

6

eissn

1387-1307

issn

1573-2614

journal_volume

20

pub_type

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