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Stochastic integrated model-based protocol for volume-controlled ventilation setting

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العنوان: Stochastic integrated model-based protocol for volume-controlled ventilation setting
المؤلفون: Lee JWW, Chiew YS, Wang X, Mat Nor MB, Desaive T, Chase, Geoff
بيانات النشر: Springer Science and Business Media LLC
سنة النشر: 2022
المجموعة: University of Canterbury, Christchurch: UC Research Repository
مصطلحات موضوعية: mechanical ventilation, stochastic modelling, respiratory mechanics, decision-making, model-based protocol, critical care, Fields of Research::40 - Engineering::4003 - Biomedical engineering, Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320103 - Respiratory diseases
الوصف: Background and objective: Mechanical ventilation (MV) is the primary form of care for respiratory failure patients. MV settings are based on general clinical guidelines, intuition, and experience. This approach is not patient-specific and patients may thus experience suboptimal, potentially harmful MV care. This study presents the Stochastic integrated VENT (SiVENT) protocol which combines model-based approaches of the VENT protocol from previous works, with stochastic modelling to take the variation of patient respiratory elastance over time into consideration. Methods: A stochastic model of Ers is integrated into the VENT protocol from previous works to develop the SiVENT protocol, to account for both intra- and inter-patient variability. A cohort of 20 virtual MV patients based on retrospective patient data are used to validate the performance of this method for volume-controlled (VC) ventilation. A performance evaluation was conducted where the SiVENT and VENT protocols were implemented in 1080 instances each to compare the two protocols and evaluate the difference in reduction of possible MV settings achieved by each. Results: From an initial number of 189,000 possible MV setting combinations, the VENT protocol reduced this number to a median of 10,612, achieving a reduction of 94.4% across the cohort. With the integration of the stochastic model component, the SiVENT protocol reduced this number from 189,000 to a median of 9329, achieving a reduction of 95.1% across the cohort. The SiVENT protocol reduces the number of possible combinations provided to the user by more than 1000 combinations as compared to the VENT protocol. Conclusions: Adding a stochastic model component into a model-based approach to selecting MV settings improves the ability of a decision support system to recommend patient-specific MV settings. It specifically considers inter- and intra-patient variability in respiratory elastance and eliminates potentially harmful settings based on clinically recommended pressure thresholds. Clinical ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
تدمد: 1475-925X
العلاقة: Lee JWW, Chiew YS, Wang X, Mat Nor MB, Chase JG, Desaive T (2022). Stochastic integrated model-based protocol for volume-controlled ventilation setting. BioMedical Engineering Online. 21(1). 13-.; https://hdl.handle.net/10092/104247Test; http://doi.org/10.1186/s12938-022-00981-0Test
DOI: 10.1186/s12938-022-00981-0
الإتاحة: https://doi.org/10.1186/s12938-022-00981-0Test
https://hdl.handle.net/10092/104247Test
حقوق: © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. To view a copy of this licence, visit http://creatTest iveco mmons. org/ licen ses/ by/4. 0/. ; http://hdl.handle.net/10092/17651Test
رقم الانضمام: edsbas.A0E652A1
قاعدة البيانات: BASE
الوصف
تدمد:1475925X
DOI:10.1186/s12938-022-00981-0