The Clinical Utilisation of Respiratory Elastance Software (CURE Soft): a bedside software for real-time respiratory mechanics monitoring and mechanical ventilation management

BioMedical Engineering OnLine

Akos Szlavecz²  Yeong Shiong Chiew⁴  Daniel Redmond⁴  Alex Beatson⁴  Daniel Glassenbury⁴  Simon Corbett⁴  Vincent Major⁴  Christopher Pretty⁴  Geoffrey M Shaw¹  Balazs Benyo²  Thomas Desaive³  J Geoffrey Chase⁴ 

[1] Department of Intensive Care, Christchurch Hospital, Canterbury, New Zealand

[2] Department of Control Engineering and Information, Budapest University of Technology and Economics, Budapest, Hungary

[3] GIGA Cardiovascular Science, University of Liege, Liege, Belgium

[4] Centre for BioEngineering, University of Canterbury, Canterbury, New Zealand

关键词: Positive End-Expiratory Pressure (PEEP);    Decision Making;    Monitoring;    Respiratory Mechanics;    Software;    Mechanical Ventilation;   

Others  :  1084297
DOI  :  10.1186/1475-925X-13-140

 received in 2014-07-09, accepted in 2014-09-20,  发布年份 2014

【 摘 要 】

Background

Real-time patient respiratory mechanics estimation can be used to guide mechanical ventilation settings, particularly, positive end-expiratory pressure (PEEP). This work presents a software, Clinical Utilisation of Respiratory Elastance (CURE Soft), using a time-varying respiratory elastance model to offer this ability to aid in mechanical ventilation treatment.

Implementation

CURE Soft is a desktop application developed in JAVA. It has two modes of operation, 1) Online real-time monitoring decision support and, 2) Offline for user education purposes, auditing, or reviewing patient care. The CURE Soft has been tested in mechanically ventilated patients with respiratory failure. The clinical protocol, software testing and use of the data were approved by the New Zealand Southern Regional Ethics Committee.

Results and discussion

Using CURE Soft, patient’s respiratory mechanics response to treatment and clinical protocol were monitored. Results showed that the patient’s respiratory elastance (Stiffness) changed with the use of muscle relaxants, and responded differently to ventilator settings. This information can be used to guide mechanical ventilation therapy and titrate optimal ventilator PEEP.

Conclusion

CURE Soft enables real-time calculation of model-based respiratory mechanics for mechanically ventilated patients. Results showed that the system is able to provide detailed, previously unavailable information on patient-specific respiratory mechanics and response to therapy in real-time. The additional insight available to clinicians provides the potential for improved decision-making, and thus improved patient care and outcomes.

【 授权许可】

   
2014 Szlavecz et al.; licensee BioMed Central Ltd.

【 图 表 】

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