Towards an intuitive expert system for weaning from artificial ventilation

The procedure for weaning a patient with respiratory insufficiency from mechanical ventilation is complex and requires expertise obtained from long clinical practice. Fuzzy knowledge-based weaning (FuzzyKBWean) is a fuzzy knowledge-based control system that proposes stepwise changes in ventilator settings during the entire period of artificial ventilation at the bedside in real time. Information is obtained from a patient data management system operating at the intensive care unit (ICU) with a time resolution of one minute. A large body of the explicitly given and implicitly available medical knowledge of an experienced intensive care specialist could be transferred to the developed fuzzy control system. Periods of deviation from the target are shorter with FuzzyKBWean. A physician, who changes the settings of the ventilator manually, applies the system in an open-loop manner in patients who have undergone cardiac surgery. To force the usability of an open-loop system an intuitive user interface approach is currently developed which allows displaying qualitative information instead of numerical information.