| Abstract | We have previously developed a fuzzy logic
controller for weaning adults with chronic
obstructive pulmonary disease using pressure
support ventilation (PSV). We used the core of our
fuzzy logic-based weaning platform and further
developed parametrizable components for weaning
newborns of differing body size and disease-state.
The controller was validated on neonates recovering
from congenital heart disease (CHD) while receiving
synchronous intermittent mandatory ventilation
(SIMV). We wished to compare the efficacy of this
controller versus the bedside weaning protocol in
children with respiratory syncytial virus
pneumonitis/bronchiolitis (RSV) in the pediatric
intensive care unit (PICU). The fuzzy controller
evaluated the “current” and “trend” weaning status
of the newborn, to quantitatively determine the
change in the SIMV integrated ventilatory setting.
For the “current” status, it used heart rate (HR),
respiratory rate (RR), tidal volume (VT) and oxygen
saturation (SaO2), while for the “trend” status, the
differences of RR/ t, HR/ t, and SaO2/ t,
recorded between two subsequent time points, were
utilized. The enumerated vital signs were fuzzified
and then probability levels of occurrence were
assigned. Individualized “golden” goals for SaO2
were set for each newborn. We retrospectively
assessed the charts of 19 newborns, 113±128 days
old, 5,546±2,321 gr body weight, weaning for 99±46
days, at 2-hour intervals. The SIMV levels proposed
by the fuzzy controller were matched to those levels
actually applied. In 60% of the time both values
coincided. For the remaining 40%, the controller was
more aggressive suggesting lower values of SIMV
than the applied ones. The Area under the SIMV
curves over time was 1,969±1,044 for the applied vs
1,886±978 for the suggested levels, respectively. The
fuzzy controller, adjusted for body size and diseasepattern,
can approximate the actual weaning course
of newborns with RSV. |