Computerized Decision Support for Mechanical Ventilation of Trauma Induced ARDS: Results of a Randomized Clinical Trial

Abstract

A computerized protocol for bedside decision support was successfully exported to a trauma center, and effectively standardized mechanical ventilatory support of trauma-induced acute respiratory distress syndrome without adverse effect on patient outcome.

The Intelligent Ventilator (INVENT) project: The role of mathematical models in translating physiological knowledge into clinical practice

“…In addition, the results presented in our studies [71,72] are inconsistent with large changes in base excess across the peripheral sampling site. Sensitivity analysis has also shown [72] that the literature reported variation in RQ variation of 0.08 gives rise to only small errors in pH, PCO 2 and PO 2 of 0.005, 0.10 kPa and 0.06 kPa, respectively.…”

“…In the intensive Care unit, and in particular in the control of mechanical ventilation, representation of heuristic reasoning can be seen currently as the most successful approach to providing decision support. This approach has produced systems which have both been tested in multi-center randomized control trials [1,2,3,4], and commercialized [1,4].…”

Computerized decision support in adult and pediatric critical care

“…Adult critical care Diagnostic DXplain [28] Mortality and length of stay prediction [9,29] Alert and reminder Ventilator induced lung injury [84] Blood pressure variability while on vasopressors [32] Adverse drug reactions [19] Drug induced thrombocytopenia [30] Epidural hematoma with neuraxial anesthesia [31] Protocol/procedure Acute respiratory distress syndrome [33][34][35] Sepsis [21] VTE prophylaxis and events in trauma patients [37] VTE prophylaxis [38,39] Tidal volume during mechanical ventilation [36] Management…”

“…In the prospective cohort study by Bertsche et al [19] , implementation of a CDS program showed significant decreases in drugdrug interactions and in adverse events related to drugdrug interactions, including prolonged QT interval and hypokalemia. Additionally, CDS improves adherence to protocols for mechanical ventilation [33][34][35][36] , sepsis [21] , and venous thromboembolism prevention [37][38][39] , and can improve patient care. Such protocol use in critical care standardizes treatments of common physiologic states and is often central to quality improvement efforts in the ICU [40] .…”

Development and simultaneous application of multiple care protocols in critical care: a multicenter feasibility study

“…Such successes include sedation [2,3], weaning from mechanical ventilation [4,5], lung-protective mechanical ventilation [6,7], goal-directed therapy in early sepsis [8] and in high-risk surgery [9,10], and hemodynamic management after cardiac surgery [11,12].…”