Title :
Adaptive multi-infusion decision support for the multivariable circulatory management of critically ill patients
Author :
Mason, David G. ; Bancroft, Jayne ; Fraser, John F.
Author_Institution :
Sch. of Inf. Technol. & Electr. Eng., Univ. of Queensland, Brisbane, QLD, Australia
fDate :
Aug. 31 2010-Sept. 4 2010
Abstract :
We have developed a novel adaptive multi-infusion advisory system for circulatory management of critically ill patients which co-ordinates infusion adjustments to ensure safe trajectories. This system should reduce patient hospital stay and improve patient outcome by enhancing the quality of patient circulatory control; alleviating the clinical cognitive load, giving staff more time for direct patient care, while also reducing infusion adjustment errors. We have applied three derived circulatory variables which relate to the three main types of cardiovascular infusions (inotropic, vasoactive and fluid). A lumped parameter steady flow model of the human circulatory system and the effects of cardiovascular infusions was constructed for algorithm development, clinical experts providing feedback on a representative test set of simulated patients in circulatory shock. Independent self-learning fuzzy logic controllers (SLFLC) were found to give good adaptation to variable patient infusion sensitivities. A supervisory, rule-based module co-ordinates infusion adjustments to ensure safe circulatory trajectories. Monitoring of manual infusion adjustments allows timely advice and also a critiquing capability which can train junior staff and reduce infusion adjustment errors. A physical mock circulatory loop was used to construct and test our physical advisory system. Preliminary clinical results show good clinical utility of our adaptive multi-infusion advisory system.
Keywords :
cardiovascular system; decision support systems; fuzzy control; haemodynamics; health care; knowledge based systems; patient care; adaptive multi-infusion advisory system; adaptive multi-infusion decision support; cardiovascular infusions; clinical cognitive load; critically ill patients; direct patient care; independent self-learning fuzzy logic controllers; infusion adjustments; lumped parameter steady flow model; multivariable circulatory management; patient hospital stay; safe trajectories; supervisory rule-based module; Biomedical monitoring; Cardiology; Computational modeling; Drugs; Fluids; Monitoring; Trajectory; Algorithms; Blood Pressure; Cardiac Output; Critical Illness; Decision Support Systems, Clinical; Fuzzy Logic; Humans; Infusion Pumps; Infusions, Intravenous; Medication Therapy Management; Models, Cardiovascular; Monitoring, Physiologic; Signal Processing, Computer-Assisted;
Conference_Titel :
Engineering in Medicine and Biology Society (EMBC), 2010 Annual International Conference of the IEEE
Conference_Location :
Buenos Aires
Print_ISBN :
978-1-4244-4123-5
DOI :
10.1109/IEMBS.2010.5627373