Document Detail


Intelligent model-based advisory system for the management of ventilated intensive care patients. Part II: Advisory system design and evaluation.
MedLine Citation:
PMID:  20398957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The optimisation of ventilatory support is a crucial issue for the management of respiratory failure in critically ill patients, aiming at improving gas exchange while preventing ventilator-induced dysfunction of the respiratory system. Clinicians often rely on their knowledge/experience and regular observation of the patient's response for adjusting the level of respiratory support. Using a similar data-driven decision-making methodology, an adaptive model-based advisory system has been designed for the clinical monitoring and management of mechanically ventilated patients. The hybrid blood gas patient model SOPAVent developed in Part I of this paper and validated against clinical data for a range of patients lung abnormalities is embedded into the advisory system to predict continuously and non-invasively the patient's respiratory response to changes in the ventilator settings. The choice of appropriate ventilator settings involves finding a balance among a selection of fundamentally competing therapeutic decisions. The design approach used here is based on a goal-directed multi-objective optimisation strategy to determine the optimal ventilator settings that effectively restore gas exchange and promote improved patient's clinical conditions. As an initial step to its clinical validation, the advisory system's closed-loop stability and performance have been assessed in a series of simulations scenarios reconstructed from real ICU patients data. The results show that the designed advisory system can generate good ventilator-setting advice under patient state changes and competing ventilator management targets.
Authors:
Ang Wang; Mahdi Mahfouf; Gary H Mills; G Panoutsos; D A Linkens; K Goode; Hoi-Fei Kwok; Mouloud Denaï
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-15
Journal Detail:
Title:  Computer methods and programs in biomedicine     Volume:  99     ISSN:  1872-7565     ISO Abbreviation:  Comput Methods Programs Biomed     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506513     Medline TA:  Comput Methods Programs Biomed     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  208-17     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Process Automation, ABB Limited, Eaton Socon, Cambridgeshire, UK. ang.wang@gb.abb.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Gas Analysis
Female
Humans
Intensive Care*
Male
Middle Aged
Respiration, Artificial / methods*
Respiratory Insufficiency / therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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