Using physiological models and decision theory for selecting appropriate ventilator settings

J Clin Monit Comput. 2006 Dec;20(6):421-9. doi: 10.1007/s10877-006-9049-5. Epub 2006 Sep 15.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carbon Dioxide / physiology
  • Computer Systems
  • Decision Theory
  • Humans
  • Mathematics
  • Models, Biological*
  • Monitoring, Physiologic
  • Oxygen / physiology
  • Respiration, Artificial / methods*
  • Respiration, Artificial / statistics & numerical data
  • Respiratory Mechanics*

Substances

  • Carbon Dioxide
  • Oxygen