| Abstract | Objectives of computerized decision support systems for mechanical ventilation are discussed. Questions
considered are: Why is computerized decision support for mechanical ventilation important? What
parameter(s) should be optimized? What are the differences between a single attribute and a multiattribute
value function used for optimization? How is it possible to achieve optimization in clinical practice with
existing ventilators? How does one solve the problem of acquiring measurement of data needed for closed
loop control? The possibilities and limitations of three existing decision support systems are discussed. 1)
Computerized protocols from LDS Hospital in Salt Lake City, Utah, USA. 2) Optimization Program
(OPTPROG) developed jointly at the Institute of Biocybernetics and Biomedical Engineering, Polish
Academy of Sciences, Warsaw, Poland and Medical Intensive Care Unit, Department of Medicine at
Karolinska Institute, South Hospital, Stockholm, Department of Medical Informatics Linkoping University,
Sweden. 3) Ventilator Therapy Planner (VENT-PLAN) from the Section on Medical Informatics at
Stanford University, Palo Alto, California, USA. Strategies leading to an optimal computerized decision
support system are proposed. These strategies include development of better measurement methods for
blood gases and cardiac output, improvement of man-machine and machine-machine interaction and the
selection of optimization criteria. Finally, research directed towards building quantitative, dynamic patient
models based on computerized databases of mechanically ventilated patients are discussed. [References:
39] |