Adaptive multi-infusion decision support for the multivariable circulatory management of critically ill patients

Mason, David G., Bancroft, Jayne and Fraser, John F. (2010). Adaptive multi-infusion decision support for the multivariable circulatory management of critically ill patients. In: , Proceedings of the 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 10), Buenos Aires, Argentina, (426-429). 30 August - 4 September 2010.


Author Mason, David G.
Bancroft, Jayne
Fraser, John F.
Title of paper Adaptive multi-infusion decision support for the multivariable circulatory management of critically ill patients
Conference name 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 10)
Conference location Buenos Aires, Argentina
Conference dates 30 August - 4 September 2010
Proceedings title Proceedings of the 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology Society   Check publisher's open access policy
Place of Publication Piscataway, NJ, United States
Publisher Institute of Electrical and Electronics Engineers
Publication Year 2010
Sub-type Fully published paper
DOI 10.1109/IEMBS.2010.5627373
ISBN 9781424441242
ISSN 1557-170X
Start page 426
End page 429
Total pages 4
Language eng
Abstract/Summary 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.
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status UQ

 
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