Automatic detection of ventilatory modes during invasive mechanical ventilation

Gastón Murias, Jaume Montanyà, Encarna Chacón, Anna Estruga, Carles Subirà, Rafael Fernández, Bernat Sales, Candelaria de Haro, Josefina López-Aguilar, Umberto Lucangelo, Jesús Villar, Robert M. Kacmarek, Lluís Blanch

    Research output: Contribution to journalArticleResearchpeer-review

    11 Citations (Scopus)

    Abstract

    © 2016 The Author(s). Background: Expert systems can help alleviate problems related to the shortage of human resources in critical care, offering expert advice in complex situations. Expert systems use contextual information to provide advice to staff. In mechanical ventilation, it is crucial for an expert system to be able to determine the ventilatory mode in use. Different manufacturers have assigned different names to similar or even identical ventilatory modes so an expert system should be able to detect the ventilatory mode. The aim of this study is to evaluate the accuracy of an algorithm to detect the ventilatory mode in use. Methods: We compared the results of a two-step algorithm designed to identify seven ventilatory modes. The algorithm was built into a software platform (BetterCare® system, Better Care SL; Barcelona, Spain) that acquires ventilatory signals through the data port of mechanical ventilators. The sample analyzed compared data from consecutive adult patients who underwent >24 h of mechanical ventilation in intensive care units (ICUs) at two hospitals. We used Cohen's kappa statistics to analyze the agreement between the results obtained with the algorithm and those recorded by ICU staff. Results: We analyzed 486 records from 73 patients. The algorithm correctly labeled the ventilatory mode in 433 (89 %). We found an unweighted Cohen's kappa index of 84.5 % [CI (95 %)=(80.5 %: 88.4 %)]. Conclusions: The computerized algorithm can reliably identify ventilatory mode.
    Original languageEnglish
    Article number258
    JournalCritical Care
    Volume20
    Issue number1
    DOIs
    Publication statusPublished - 14 Aug 2016

    Keywords

    • Automatic detection
    • Information systems in critical care
    • Mechanical ventilation
    • Ventilatory mode

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