Automatic detection of ventilatory modes during invasive mechanical ventilation.

Background: Expert systems can help alleviate problems related to the shortage of human resources in critical care, offering expert advice in complex situations. Expert systems use contextual information to provide advice to staff. In mechanical ventilation, it is crucial for an expert system to be...

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Published in:Critical Care Vol. 20; pp. 1 - 8
Main Authors: Murias, Gastón, Montanyà, Jaume, Chacón, Encarna, Estruga, Anna, Subirà, Carles, Fernández, Rafael, Sales, Bernat, de Haro, Candelaria, López-Aguilar, Josefina, Lucangelo, Umberto, Villar, Jesús, Kacmarek, Robert M., Blanch, Lluís
Format: equations & formulas pictorial research tables/charts Journal Article
Published: BioMed Central 8/14/2016
Online Access:View this record in EBSCOhost
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      dt: 8/14/2016
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      pub: BioMed Central
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        10.1186/s13054-016-1436-9
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        atl: Automatic detection of ventilatory modes during invasive mechanical ventilation.
      aug:
        au:
          Murias, Gastón
          Montanyà, Jaume
          Chacón, Encarna
          Estruga, Anna
          Subirà, Carles
          Fernández, Rafael
          Sales, Bernat
          de Haro, Candelaria
          López-Aguilar, Josefina
          Lucangelo, Umberto
          Villar, Jesús
          Kacmarek, Robert M.
          Blanch, Lluís
        affil: Clínica Bazterrica y Clínica Santa Isabel, Departamento de Ciencias Fisiológicas, Farmacológicas y Bioquímicas, Facultad de Medicina, Universidad Favaloro, Buenos Aires, Argentina
      sug:
        subj:
          Respiration, Artificial Methods
          Equipment Design
          Respiration, Artificial Equipment and Supplies
          Ventilators, Mechanical Trends
          Decision Support Systems, Clinical Standards
          Decision Support Systems, Clinical Equipment and Supplies
          Intensive Care Units Administration
          Automation Equipment and Supplies
          Decision Support Systems, Clinical Trends
          Automation Methods
          Intensive Care Units Labor Supply
          Spain
          Respiration, Artificial Nursing
          Equipment Design Trends
          Algorithms
          Human
      ab: Background: Expert systems can help alleviate problems related to the shortage of human resources in critical care, offering expert advice in complex situations. Expert systems use contextual information to provide advice to staff. In mechanical ventilation, it is crucial for an expert system to be able to determine the ventilatory mode in use. Different manufacturers have assigned different names to similar or even identical ventilatory modes so an expert system should be able to detect the ventilatory mode. The aim of this study is to evaluate the accuracy of an algorithm to detect the ventilatory mode in use.Methods: We compared the results of a two-step algorithm designed to identify seven ventilatory modes. The algorithm was built into a software platform (BetterCare® system, Better Care SL; Barcelona, Spain) that acquires ventilatory signals through the data port of mechanical ventilators. The sample analyzed compared data from consecutive adult patients who underwent >24 h of mechanical ventilation in intensive care units (ICUs) at two hospitals. We used Cohen's kappa statistics to analyze the agreement between the results obtained with the algorithm and those recorded by ICU staff.Results: We analyzed 486 records from 73 patients. The algorithm correctly labeled the ventilatory mode in 433 (89 %). We found an unweighted Cohen's kappa index of 84.5 % [CI (95 %) = (80.5 %: 88.4 %)].Conclusions: The computerized algorithm can reliably identify ventilatory mode.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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