Critical Events in Mechanically Ventilated Patients

Abstract

Abstract. Mechanical Ventilation is an artificial way to help a Patient to breathe. This procedure is used to support patients with respiratory diseases however in many cases it can provoke lung damages, Acute Respiratory Diseases or organ failure. With the goal to early detect possible patient breath problems a set of limit values was defined to some variables monitored by the ventilator (Average Ventilation Pressure, Compliance Dynamic, Flow, Peak, Plateau and Support Pressure, Positive end-expiratory pressure, Respiratory Rate) in order to create critical events. A critical event is verified when a patient has a value higher or lower than the normal range defined for a certain period of time. The values were defined after elaborate a literature review and meeting with physicians specialized in the area. This work uses data streaming and intelligent agents to process the values collected in real-time and classify them as critical or not. Real data provided by an Intensive Care Unit were used to design and test the solution. In this study it was possible to understand the importance of introduce critical events for Mechanically Ventilated Patients. In some cases a value is considered critical (can trigger an alarm) however it is a single event (instantaneous) and it has not a clinical significance for the patient. The introduction of critical events which crosses a range of values and a predefined duration contributes to improve the decision-making process by decreasing the number of false positives and having a better comprehension of the patient condition.

Applied Pervasive Patient Timeline in Intensive Care Units

“…Critical events occur when a patient has a higher or lower value than the predefined normal range, for a period of time. The range of values was determined after a literature review and counselling of specialized physicians to have the most reliable range possible (Portela et al, 2016). On the timeline, an event value is verified if it is between or outside the normal range, and then it is defined as critical or not.…”

Data Quality and Critical Events in Ventilation

“…These procedures are usually based on the use of intelligent agents (Cardoso et al, 2014). In this field, a set of experiments was made to define and detect critical events in the respiratory system (Portela, Gago, Santos, Silva, & Rua, 2012;Portela, Gago, et al, 2013;Portela et al, 2016).…”

“…In a previous work, the Critical Event concept (Portela, Gago, et al, 2012;Silva et al, 2008) was applied to mechanical ventilation patients (Portela et al, 2016). The critical event ranges were defined by analysing the literature and the use of expert knowledge provided by the intensivists (Intensive Medicine professionals).…”

“…In this study, it was possible to observe that 2% of the values collected were noise values and 50% represented a Critical Event. This study is a sequel of a study previously conducted where the Critical Events concept was applied to mechanically ventilated patients (Portela et al, 2016).…”