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Oxygenation advisor recommends appropriate positive end expiratory pressure and FIO2 settings: retrospective validation study
- Source :
- Journal of clinical monitoring and computing. 28(2)
- Publication Year :
- 2013
-
Abstract
- A decision support, rule-based oxygenation advisor that provides guidance for setting positive end expiratory pressure (PEEP) and fractional inhaled oxygen concentration (FIO2) for patients with respiratory failure is described. The target oxygenation goal is to achieve and maintain pulse oximeter oxygen saturation (SpO2) ≥88 and ≤95 %, as posited by the Acute Respiratory Distress Syndrome Network, by recommending appropriate combinations of PEEP and FIO2. For patient safety, the oxygenation advisor monitors mean arterial blood pressure (MAP) to ensure it is ≥65 mmHg for hemodynamic stability and inspiratory plateau pressure (Pplt) so it is ≤30 cm H2O for lung protection. The purpose of this validation study was to compare attending physicians’ recommendations to those recommendations of the oxygenation advisor for setting PEEP and FIO2. Adults with respiratory failure (n = 117) receiving ventilatory support were studied. PEEP, FIO2, SpO2, MAP, and Pplt are input variables into the advisor. Recommendations to increase, maintain, or decrease PEEP and FIO2 are the oxygenation advisor’s output variables. Physicians’ recommendations for setting PEEP and FIO2 were recorded; the oxygenation advisor’s recommendations were also recorded for comparison. At all times, ventilator settings were based on recommendations from attending physicians. PEEP ranged from 2 to 22 cm H2O and FIO2 ranged from 0.30 to 0.65. A total of 326 recommendations by the oxygenation advisor and attending physicians were made to increase, maintain, or decrease PEEP and FIO2. There was a very significant relationship (p
- Subjects :
- Male
medicine.medical_specialty
education
Health Informatics
Critical Care and Intensive Care Medicine
Sensitivity and Specificity
Positive-Pressure Respiration
Plateau pressure
Anesthesiology
medicine
Humans
Oximetry
Positive end-expiratory pressure
Oxygen saturation (medicine)
Retrospective Studies
business.industry
Oxygen Inhalation Therapy
Reproducibility of Results
Retrospective cohort study
Oxygenation
respiratory system
Middle Aged
respiratory tract diseases
Anesthesiology and Pain Medicine
Blood pressure
Treatment Outcome
Respiratory failure
Breath Tests
Therapy, Computer-Assisted
Physical therapy
Female
Blood Gas Analysis
business
Respiratory Insufficiency
therapeutics
circulatory and respiratory physiology
Subjects
Details
- ISSN :
- 15732614
- Volume :
- 28
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of clinical monitoring and computing
- Accession number :
- edsair.doi.dedup.....29b1944387b3acf38efd4e2d61a81ad7