Non-invasive ventilation treatment for patients with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) affects the lives of millions of patients worldwide. Patients with advanced COPD may require non-invasive ventilation (NIV) to support the resultant deficiencies of the respiratory system. The purpose of this study was to evaluate the effects of varying the continuous positive airway pressure (CPAP) and oxygen supplementation components of NIV on simulated COPD patients by using an established and detailed model of the human respiratory system.

Computerised decision support for differential lung ventilation.

Differential lung ventilation treatment is a mechanical ventilation strategy used for unilateral lung disease or injury. This treatment can be provided to patients who fail to respond to conventional mechanical ventilation to both lungs and is technically challenging to medical personnel. An effective computerised decision support system (CDSS) can be used as a support system to intensivists in providing this treatment to their patients.

Continuous Positive Airway Pressure treatment of premature infants; application of a computerized decision support system.

The predictions of a computerized decision-support system (CDSS) are compared to clinical data obtained from a group of premature infants. The infants were suffering from respiratory distress syndrome (RDS) and were treated by the Continuous Positive Airway Pressure (CPAP) therapy. The predictions of the CDSS are found to be in general agreement with clinical measurements.

A computerized decision support system to predict the variations in the cerebral blood flow of mechanically ventilated infants.

A computerized decision support system is described to predict the changes in the cerebral blood flow (CBF) of mechanically ventilated infants in response to different ventilatory settings. A CBF controller was developed and combined with a mathematical model of the infant's respiratory system to simulate the effects of ventilatory settings on the infant's CBF. The performance of the system was examined under various ventilatory treatments and the results were compared with available experimental data.

A control system for mechanical ventilation of passive and active subjects.

Synchronization of spontaneous breathing with breaths supplied by the ventilator is essential for providing optimal ventilation to patients on mechanical ventilation. Some ventilation techniques such as Adaptive Support Ventilation (ASV), Proportional Assist Ventilation (PAV), and Neurally Adjusted Ventilatory Assist (NAVA) are designed to address this problem. In PAV, the pressure support is proportional to the patient's ongoing effort during inspiration.

A closed-loop system for control of the fraction of inspired oxygen and the positive end-expiratory pressure in mechanical ventilation.

A system for automatic control of the fraction of inspired oxygen (F(IO2)), and positive end-expiratory pressure (PEEP) for patients on mechanical ventilation is presented. In this system, F(IO2) is controlled by using two interacting mechanisms; a fine control mechanism and a fast stepwise procedure used when patient's oxygen saturation level (S(pO2)) falls abruptly. The PEEP level is controlled automatically and in relation to F(IO2) to prevent hypoxemia.

A model-based decision support system for critiquing mechanical ventilation treatments.

A computerized system for critiquing mechanical ventilation treatments is presented that can be used as an aide to the intensivist. The presented system is based on the physiological model of the subject's respiratory system. It uses modified versions of previously developed models of adult and neonatal respiratory systems to simulate the effects of different ventilator treatments on the patient's blood gases.

Critiquing treatment and setting ventilatory parameters by using physiological modeling.

A modeling system is presented that can be used to predict the effects of ventilatory settings on the blood gases of patients on mechanical ventilation. The system uses a physiological model of the patient that includes lungs, body tissue, and brain tissue compartments. The model includes the effects of changes in the cardiac output and cerebral blood flow and lung mechanical factors.

Evaluation of a computerized system for mechanical ventilation of infants.

Objective: To evaluate a computerized system for mechanical ventilation of infants.

Methods: FLEX is a computerized system that includes the features of a patented mode known as adaptive-support ventilation (ASV). In addition, it has many other features including adjustment of positive end-expiratory pressure (PEEP), fraction of inspired oxygen (F(IO2)), minute ventilation, and control of weaning.

Automatic control of mechanical ventilation. Part 2: the existing techniques and future trends.

Objective: The major automatic techniques that are available in commercial ventilators are described and a discussion of the recently developed systems along with the future trends in the field is provided.

Methods: The major available automatic control techniques for mechanical ventilation are analyzed and the future trends are discussed in view of today's ICU requirements and the recently developed technologies.

Results: Several major automatic techniques are available in commercial ventilators at this time.

Automatic control of mechanical ventilation. Part 1: theory and history of the technology.

Objective: In this article, automatic control technology as applied to mechanical ventilation is discussed and the techniques that have been reported in the literature are reviewed.

Methods: The information in the literature is reviewed and various techniques are compared.

Results: Automatic control has been applied in many ways to mechanical ventilation since several decades ago.

Intelligent decision support systems for mechanical ventilation.

Objective: An overview of different methodologies used in various intelligent decision support systems (IDSSs) for mechanical ventilation is provided. The applications of the techniques are compared in view of today's intensive care unit (ICU) requirements.

Methods: Information available in the literature is utilized to provide a methodological review of different systems.

Flex: a new computerized system for mechanical ventilation.

Objective: To describe and evaluate a new weaning and decision support system for mechanical ventilation.

Background: FLEX is a computerized weaning and decision support system for mechanical ventilation that unlike previous rule-based systems derives many of its rules on the basis of the conditions of individual patients. This system can be used in a wide range of ventilatory modes as well as automatic control of weaning.

A new decision support system for mechanical ventilation.

A decision support system has been developed for the treatment and management of patients on mechanical ventilation. The following criteria have been used in the design of the system; a) to regulate arterial blood gases within the normal range, b) to optimize ventilatory treatment in order to minimize the breathing work rate, and c) to reduce the weaning time from the ventilator. The system incorporates many safety features and can be used as an advisory tool as well as an informative source of patient data.

A dual closed-loop control system for mechanical ventilation.

Objective: Closed-loop mechanical ventilation has the potential to provide more effective ventilatory support to patients with less complexity than conventional ventilation. The purpose of this study was to investigate the effectiveness of an automatic technique for mechanical ventilation.

Methods: Two closed-loop control systems for mechanical ventilation are combined in this study.

Function of brainstem neurons in optimal control of respiratory mechanics.

An optimization control procedure is developed to describe the function of the human respiratory controller in determination of the respiratory frequency, the expiratory reserve volume, and the physiological dead space volume at all levels of human activity. The required level of alveolar ventilation is considered to have been determined based on the inputs from the peripheral and central chemoreceptors. The proposed procedure describes the mechanical control of breathing in which the excitation signals are adjusted and transferred from the neuron pools in the brainstem to the respiratory muscles to control the rate and depth of breathing.

Closed-loop control if the inspired fraction of oxygen in mechanical ventilation.

Objective: Supplemental oxygen treatment of patients on mechanical ventilation is crucial in maintaining the patients' oxygen levels in the normal range. The purpose of this study was to evaluate the effectiveness of a closed-loop controller for automatic adjustment of the fraction of inspired oxygen, FIO2. More specifically, the aim of the study was to assess the robustness of the controller in correcting hypoxemia as well as its effectiveness in prevention of hyperoxemia and oxygen toxicity.