Literature DB >> 21454039

Variability of preference toward mechanical ventilator settings: a model-based behavioral analysis.

Charlotte Allerød1, Dan S Karbing, Per Thorgaard, Steen Andreassen, Søren Kjærgaard, Stephen E Rees.   

Abstract

PURPOSE: The purpose of this study was to evaluate Danish clinicians' opinions toward ventilator settings using standardized model-simulated patients. The models ensured that all clinicians received identical presentations of data and anticipated responses to changes in patient state, enabling opinions on the same patient cases to be obtained from different clinicians.
MATERIALS AND METHODS: Ten Danish intensive care clinicians' and a computerized decision support system each provided suggestions for respiratory frequency (f), tidal volume (Vt) and insoired oxygen fraction (FiO2) in the same 10 model-simulated patient cases. The 110 suggestions were then evaluated by the 10 clinicians in a ranking and classification procedure.
RESULTS: Clinicians' preferences toward ventilator settings (Fio(2), Vt, and f) and the resulting simulated values of arterial oxygen saturation, peak inspiratory pressure, and pH were significantly different (P < .005). The results of the classification showed that clinicians generally had poor opinion of the advice provided by other clinicians and the decision support system, considering this advice to be unacceptable in 33% of cases and good only in 21%. The ranking procedure also showed that clinicians did not agree on the best and worst advice.
CONCLUSION: The present study shows significant difference in opinion on appropriate settings of f, Vt, and Fio(2) in the same computerized decision support system model-simulated patient cases.
Copyright © 2011 Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21454039     DOI: 10.1016/j.jcrc.2011.01.006

Source DB:  PubMed          Journal:  J Crit Care        ISSN: 0883-9441            Impact factor:   3.425


  5 in total

Review 1.  Journal of clinical monitoring and computing 2014 end of year summary: respiration.

Authors:  D S Karbing; S E Rees; M B Jaffe
Journal:  J Clin Monit Comput       Date:  2015-03-04       Impact factor: 2.502

2.  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

3.  Elucidating the fuzziness in physician decision making in ARDS.

Authors:  David B Bernstein; Binh Nguyen; Gilman B Allen; Jason H T Bates
Journal:  J Clin Monit Comput       Date:  2013-03-06       Impact factor: 2.502

4.  Clinical verification of a clinical decision support system for ventilator weaning.

Authors:  Jiin-Chyr Hsu; Yung-Fu Chen; Wei-Sheng Chung; Tan-Hsu Tan; Tainsong Chen; John Y Chiang
Journal:  Biomed Eng Online       Date:  2013-12-09       Impact factor: 2.819

5.  Simulation Training for Residents Focused on Mechanical Ventilation: A Randomized Trial Using Mannequin-Based Versus Computer-Based Simulation.

Authors:  Savino Spadaro; Dan Stieper Karbing; Alberto Fogagnolo; Riccardo Ragazzi; Francesco Mojoli; Luca Astolfi; Antonio Gioia; Elisabetta Marangoni; Stephen Edward Rees; Carlo Alberto Volta
Journal:  Simul Healthc       Date:  2017-12       Impact factor: 1.929

  5 in total

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