Value of elementary, combined, and modeled hemodynamic variables

Squara, Pierre; Journois, Didier; Formela, Jean-François; Schremmer, Bruno; Dhainaut, Jean-François; Bleichner, G

doi:10.1016/0883-9441(94)90002-7

Cited by 17 publications

(20 citation statements)

References 38 publications

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“…1) and as a diagnostic list (Table 1, column 3). This computer program has been validated by two studies: hemodynamic objectives proposed by the computer have better prognostic values than traditional calculated variables [22,23] and the final diagnostic of the computer is at least comparable to that of human experts [22,23]. After reading this information, the resident could either change or maintain his or her diagnosis (column 4) and treatment suggestions (column 6).…”

Section: Methodsmentioning

confidence: 99%

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A computer program for interpreting pulmonary artery catheterization data: results of the European HEMODYN Resident Study

et al. 2003

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We previously validated an expert computer program (Hemodyn) designed to assist in interpreting pulmonary artery catheterization data. The present multicentric study assessed the influence of Hemodyn on the therapeutic strategies of residents. Each resident made several diagnostic choices and suggested appropriate treatments based on pulmonary artery catheterization (PAC) data. After knowledge of the computer interpretation, the resident could either maintain or change his or her diagnosis and treatment under a senior supervision. Agreement between the residents' initial evaluation and the computer's was poor (kappa <0.6). After computer assistance, agreement improved dramatically (kappa >0.9). Computer assistance led the residents to change at least one suggested treatment in 63% of cases, and in 8% of cases the residents changed the initial suggestion to its opposite. Expert software capable of helping residents to interpret PAC data properly may improve the quality of care given to critically ill patients.

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Section: Methodsmentioning

confidence: 99%

“…Lack of these attributes may prevent clinicians from using PAC in a way that benefits their patients. In a previous study, we clinically validated an expert computer program (Hemodyn) designed to assist in interpreting PAC data [22,23]. This tool may help with tasks 3-6 and factors (a) and (e).…”

Section: Introductionmentioning

confidence: 99%

A computer program for interpreting pulmonary artery catheterization data: results of the European HEMODYN Resident Study

et al. 2003

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“…Within this scope, a haemodynamic physiologic and pathologic model has been developed for a complete computerized haemodynamic diagnosis in the 1990's [1, 2]. In this model, all mechanisms of shock are supposed to stem from tissue oxygen demand outstripping oxygen supply.…”

Section: Functional Approachmentioning

confidence: 99%

Toward Intelligent Hemodynamic Monitoring: A Functional Approach

Squara

Waldmann

2012

Cardiology Research and Practice

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Technology is now available to allow a complete haemodynamic analysis; however this is only used in a small proportion of patients and seems to occur when the medical staff have the time and inclination. As a result of this, significant delays occur between an event, its diagnosis and therefore, any treatment required. We can speculate that we should be able to collect enough real time information to make a complete, real time, haemodynamic diagnosis in all critically ill patients. This article advocates for “intelligent haemodynamic monitoring”. Following the steps of a functional analysis, we answered six basic questions. (1) What is the actual best theoretical model for describing haemodynamic disorders? (2) What are the needed and necessary input/output data for describing this model? (3) What are the specific quality criteria and tolerances for collecting each input variable? (4) Based on these criteria, what are the validated available technologies for monitoring each input variable, continuously, real time, and if possible non-invasively? (5) How can we integrate all the needed reliably monitored input variables into the same system for continuously describing the global haemodynamic model? (6) Is it possible to implement this global model into intelligent programs that are able to differentiate clinically relevant changes as opposed to artificial changes and to display intelligent messages and/or diagnoses?

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“…La caída en el VO 2 se relaciona a aumento en la mortalidad de los pacientes sépticos 69 , por lo que asegurar un DO 2 suficiente para mantener el VO 2 tisular mejora el pronóstico de los enfermos. La dependencia VO 2 al DO 2 predomina en las etapas iniciales de la sepsis como mecanismos fisiopatológico del SDMO.…”

Section: Conclusionesunclassified