When the value of gold is zero

Chase, J. Geoffrey; Möeller, Knut; Schranz, Christoph; Chiew, Yeong Shiong; Desaive, Thomas

doi:10.1186/1756-0500-7-404

Cited by 21 publications

(8 citation statements)

References 12 publications

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“…3, are very large, as they compare with the mean CO value. This observation reconfirms the difficulty of obtaining reliable measurements in critical care [9], in particular for CO [1].…”

Section: Comparison Between Techniquesmentioning

confidence: 70%

A comparison between four techniques to measure cardiac output

Pironet

Dauby

Chase

et al. 2016

2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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“…3, are very large, as they compare with the mean CO value. This observation reconfirms the difficulty of obtaining reliable measurements in critical care [9], in particular for CO [1].…”

Section: Comparison Between Techniquesmentioning

confidence: 70%

A comparison between four techniques to measure cardiac output

Pironet

Dauby

Chase

et al. 2016

2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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“…For example, PEEP can be set using computerized tomography scan (CT-scan) to maximize lung recruitment. However, CT-scans are costly and invasive, thus, it is not frequently used for setting MV PEEP [88]. Hence, clinicians are resorted to set MV based on generalized guide, as well as based on their clinical experience and intuition [65], [74], [89], [90].…”

Section: Discussionmentioning

confidence: 99%

Network Data Acquisition and Monitoring System for Intensive Care Mechanical Ventilation Treatment

Chiew

Wang

et al. 2021

IEEE Access

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The rise of model-based and machine learning methods have created increasingly realistic opportunities to implement personalized, patient-specific mechanical ventilation (MV) in the ICU. These methods require monitoring of real-time patient ventilation waveform data (VWD) during MV treatment. However, there are relatively few non-invasive and/or non-proprietary systems to monitor and record patientspecific lung condition in real-time. In this paper, we present a CARE network data acquisition and monitoring system (CARENet) to automate data collection and to remotely monitor patient-specific lung condition and ventilation parameters. The automated system acquires VWD from a mechanical ventilator using a data acquisition device (DAQ), stores data in network-attached storage (NAS), and processes VWDs via a data management platform (DMP) web application. The web application enables real-time and retrospective modelbased monitoring and analysis of clinical MV data. In particular, CARENet provides detailed breath-by-breath patient-specific respiratory mechanics, as well as the overall trends assessing changes in patient condition. Validation testing with a retrospective data set illustrated how breath-to-breath and time-varying patientventilator interaction during MV can be monitored, and, in turn, can be used to guide MV treatment. The network data acquisition system design presented is low-cost, open, and enables continuous, automated, scalable, realtime collection and analysis of waveform data, to help improve decision making, care, and outcomes in MV.

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“…Finally, model-based MV research is not without challenge. It is often hindered by the need of specialised clinical protocols [ 38 , 210 – 213 ], results comparison and validation [ 62 , 214 , 215 ], data quality, and model identification [ 190 , 212 , 216 ]. Ultimately, the need for large randomised controlled trials is a further limitation.…”

Section: The Path Forward For Mechanical Ventilation and The Role Of mentioning

confidence: 99%

Biomedical engineer’s guide to the clinical aspects of intensive care mechanical ventilation

et al. 2018

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BackgroundMechanical ventilation is an essential therapy to support critically ill respiratory failure patients. Current standards of care consist of generalised approaches, such as the use of positive end expiratory pressure to inspired oxygen fraction (PEEP–FiO2) tables, which fail to account for the inter- and intra-patient variability between and within patients. The benefits of higher or lower tidal volume, PEEP, and other settings are highly debated and no consensus has been reached. Moreover, clinicians implicitly account for patient-specific factors such as disease condition and progression as they manually titrate ventilator settings. Hence, care is highly variable and potentially often non-optimal. These conditions create a situation that could benefit greatly from an engineered approach. The overall goal is a review of ventilation that is accessible to both clinicians and engineers, to bridge the divide between the two fields and enable collaboration to improve patient care and outcomes. This review does not take the form of a typical systematic review. Instead, it defines the standard terminology and introduces key clinical and biomedical measurements before introducing the key clinical studies and their influence in clinical practice which in turn flows into the needs and requirements around how biomedical engineering research can play a role in improving care. Given the significant clinical research to date and its impact on this complex area of care, this review thus provides a tutorial introduction around the review of the state of the art relevant to a biomedical engineering perspective.DiscussionThis review presents the significant clinical aspects and variables of ventilation management, the potential risks associated with suboptimal ventilation management, and a review of the major recent attempts to improve ventilation in the context of these variables. The unique aspect of this review is a focus on these key elements relevant to engineering new approaches. In particular, the need for ventilation strategies which consider, and directly account for, the significant differences in patient condition, disease etiology, and progression within patients is demonstrated with the subsequent requirement for optimal ventilation strategies to titrate for patient- and time-specific conditions.ConclusionEngineered, protective lung strategies that can directly account for and manage inter- and intra-patient variability thus offer great potential to improve both individual care, as well as cohort clinical outcomes.

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When the value of gold is zero

Cited by 21 publications

References 12 publications

A comparison between four techniques to measure cardiac output

A comparison between four techniques to measure cardiac output

Network Data Acquisition and Monitoring System for Intensive Care Mechanical Ventilation Treatment

Biomedical engineer’s guide to the clinical aspects of intensive care mechanical ventilation

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