Literature DB >> 16977430

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

S E Rees1, C Allerød, D Murley, Y Zhao, B W Smith, S Kjaergaard, P Thorgaard, S Andreassen.   

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.

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Year:  2006        PMID: 16977430     DOI: 10.1007/s10877-006-9049-5

Source DB:  PubMed          Journal:  J Clin Monit Comput        ISSN: 1387-1307            Impact factor:   2.502


  21 in total

1.  Modelling of hypoxaemia after gynaecological laparotomy.

Authors:  S Kjaergaard; S E Rees; J A Nielsen; M Freundlich; P Thorgaard; S Andreassen
Journal:  Acta Anaesthesiol Scand       Date:  2001-03       Impact factor: 2.105

2.  Hypoxemia after coronary bypass surgery modeled by resistance to oxygen diffusion.

Authors:  S Andreassen; S E Rees; S Kjaergaard; P Thorgaard; S M Winter; C J Morgan; P Alstrup; E Toft
Journal:  Crit Care Med       Date:  1999-11       Impact factor: 7.598

3.  Computer-driven management of prolonged mechanical ventilation and weaning: a pilot study.

Authors:  Lila Bouadma; François Lellouche; Belen Cabello; Solenne Taillé; Jordi Mancebo; Michel Dojat; Laurent Brochard
Journal:  Intensive Care Med       Date:  2005-08-23       Impact factor: 17.440

4.  Mathematical models of oxygen and carbon dioxide storage and transport: the acid-base chemistry of blood.

Authors:  S E Rees; S Andreassen
Journal:  Crit Rev Biomed Eng       Date:  2005

5.  Is the placement of a pulmonary artery catheter still justified solely for the measurement of cardiac output?

Authors:  S G Sakka; K Reinhart; K Wegscheider; A Meier-Hellmann
Journal:  J Cardiothorac Vasc Anesth       Date:  2000-04       Impact factor: 2.628

6.  Oxygenation within the first 120 h following coronary artery bypass grafting. Influence of systemic hypothermia (32 degrees C) or normothermia (36 degrees C) during the cardiopulmonary bypass: a randomized clinical trial.

Authors:  B S Rasmussen; J Sollid; S E Rees; S Kjaergaard; D Murley; E Toft
Journal:  Acta Anaesthesiol Scand       Date:  2006-01       Impact factor: 2.105

Review 7.  Current status of mechanical ventilation decision support systems: a review.

Authors:  R Rudowski; T D East; R M Gardner
Journal:  Int J Clin Monit Comput       Date:  1996-08

8.  Hypoxaemia after cardiac surgery: clinical application of a model of pulmonary gas exchange.

Authors:  S Kjaergaard; S E Rees; J Grønlund; E M Nielsen; P Lambert; P Thorgaard; E Toft; S Andreassen
Journal:  Eur J Anaesthesiol       Date:  2004-04       Impact factor: 4.330

9.  Comparison of central-venous to mixed-venous oxygen saturation during changes in oxygen supply/demand.

Authors:  K Reinhart; T Rudolph; D L Bredle; L Hannemann; S M Cain
Journal:  Chest       Date:  1989-06       Impact factor: 9.410

10.  The design and implementation of a ventilator-management advisor.

Authors:  G W Rutledge; G E Thomsen; B R Farr; M A Tovar; J X Polaschek; I A Beinlich; L B Sheiner; L M Fagan
Journal:  Artif Intell Med       Date:  1993-02       Impact factor: 5.326

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  18 in total

1.  A model-based decision support system for critiquing mechanical ventilation treatments.

Authors:  Fleur T Tehrani; Soraya Abbasi
Journal:  J Clin Monit Comput       Date:  2012-04-25       Impact factor: 2.502

2.  A knowledge- and model-based system for automated weaning from mechanical ventilation: technical description and first clinical application.

Authors:  Dirk Schädler; Stefan Mersmann; Inéz Frerichs; Gunnar Elke; Thomas Semmel-Griebeler; Oliver Noll; Sven Pulletz; Günther Zick; Matthias David; Wolfgang Heinrichs; Jens Scholz; Norbert Weiler
Journal:  J Clin Monit Comput       Date:  2013-07-28       Impact factor: 2.502

3.  Clinical refinement of the automatic lung parameter estimator (ALPE).

Authors:  Lars P Thomsen; Dan S Karbing; Bram W Smith; David Murley; Ulla M Weinreich; Søren Kjærgaard; Egon Toft; Per Thorgaard; Steen Andreassen; Stephen E Rees
Journal:  J Clin Monit Comput       Date:  2013-02-21       Impact factor: 2.502

4.  Retrospective evaluation of a decision support system for controlled mechanical ventilation.

Authors:  Dan S Karbing; Charlotte Allerød; Lars P Thomsen; Kurt Espersen; Per Thorgaard; Steen Andreassen; Søren Kjærgaard; Stephen E Rees
Journal:  Med Biol Eng Comput       Date:  2011-11-22       Impact factor: 2.602

Review 5.  Paediatric models in motion: requirements for model-based decision support at the bedside.

Authors:  Jeffrey S Barrett
Journal:  Br J Clin Pharmacol       Date:  2015-01       Impact factor: 4.335

6.  Mathematical modelling of the acid-base chemistry and oxygenation of blood: a mass balance, mass action approach including plasma and red blood cells.

Authors:  Stephen Edward Rees; Elise Klaestrup; Jonathan Handy; Steen Andreassen; Søren Risom Kristensen
Journal:  Eur J Appl Physiol       Date:  2009-10-16       Impact factor: 3.078

7.  Flex: a new computerized system for mechanical ventilation.

Authors:  Fleur T Tehrani; James H Roum
Journal:  J Clin Monit Comput       Date:  2008-03-07       Impact factor: 2.502

8.  Oxygenation advisor recommends appropriate positive end expiratory pressure and FIO2 settings: retrospective validation study.

Authors:  Michael J Banner; Neil R Euliano; David Grooms; A Daniel Martin; Nawar Al-Rawas; Andrea Gabrielli
Journal:  J Clin Monit Comput       Date:  2013-10-18       Impact factor: 2.502

9.  Enabling a learning healthcare system with automated computer protocols that produce replicable and personalized clinician actions.

Authors:  Alan H Morris; Brian Stagg; Michael Lanspa; James Orme; Terry P Clemmer; Lindell K Weaver; Frank Thomas; Colin K Grissom; Ellie Hirshberg; Thomas D East; Carrie Jane Wallace; Michael P Young; Dean F Sittig; Antonio Pesenti; Michela Bombino; Eduardo Beck; Katherine A Sward; Charlene Weir; Shobha S Phansalkar; Gordon R Bernard; B Taylor Thompson; Roy Brower; Jonathon D Truwit; Jay Steingrub; R Duncan Hite; Douglas F Willson; Jerry J Zimmerman; Vinay M Nadkarni; Adrienne Randolph; Martha A Q Curley; Christopher J L Newth; Jacques Lacroix; Michael S D Agus; Kang H Lee; Bennett P deBoisblanc; R Scott Evans; Dean K Sorenson; Anthony Wong; Michael V Boland; David W Grainger; Willard H Dere; Alan S Crandall; Julio C Facelli; Stanley M Huff; Peter J Haug; Ulrike Pielmeier; Stephen E Rees; Dan S Karbing; Steen Andreassen; Eddy Fan; Roberta M Goldring; Kenneth I Berger; Beno W Oppenheimer; E Wesley Ely; Ognjen Gajic; Brian Pickering; David A Schoenfeld; Irena Tocino; Russell S Gonnering; Peter J Pronovost; Lucy A Savitz; Didier Dreyfuss; Arthur S Slutsky; James D Crapo; Derek Angus; Michael R Pinsky; Brent James; Donald Berwick
Journal:  J Am Med Inform Assoc       Date:  2021-06-12       Impact factor: 4.497

10.  Simulations for mechanical ventilation in children: review and future prospects.

Authors:  Olivier Flechelles; Annie Ho; Patrice Hernert; Guillaume Emeriaud; Nesrine Zaglam; Farida Cheriet; Philippe A Jouvet
Journal:  Crit Care Res Pract       Date:  2013-03-07
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