Model-based patient matching for in-parallel pressure-controlled ventilation

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
Springer Science and Business Media LLC
Journal Title
Journal ISSN
Volume Title
Language
eng
Date
2022
Authors
Wong JW
Chiew YS
Desaive T
Chase, Geoff
Abstract

Background: Surges of COVID-19 infections have led to insufficient supply of mechanical ventilators (MV), resulting in rationing of MV care. In-parallel, co-mechanical ventilation (Co-MV) of multiple patients is a potential solution. However, due to lack of testing, there is currently no means to match ventilation requirements or patients, with no guidelines to date. In this research, we have developed a model-based method for patient matching for pressure control mode MV. Methods: The model-based method uses a single-compartment lung model (SCM) to simulate the resultant tidal volume of patient pairs at a set ventilation setting. If both patients meet specified safe ventilation criteria under similar ventilation settings, the actual mechanical ventilator settings for Co-MV are determined via simulation using a double-compartment lung model (DCM). This method allows clinicians to analyse Co-MV in silico, before clinical implementation. Results: The proposed method demonstrates successful patient matching and MV setting in a model-based simulation as well as good discrimination to avoid mismatched patient pairs. The pairing process is based on model-based, patient-specific respiratory mechanics identified from measured data to provide useful information for guiding care. Specifically, the matching is performed via estimation of MV delivered tidal volume (mL/kg) based on patient-specific respiratory mechanics. This information can provide insights for the clinicians to evaluate the subsequent effects of Co-MV. In addition, it was also found that Co-MV patients with highly restrictive respiratory mechanics and obese patients must be performed with extra care. Conclusion: This approach allows clinicians to analyse patient matching in a virtual environment without patient risk. The approach is tested in simulation, but the results justify the necessary clinical validation in human trials.

Description
Citation
Wong JW, Chiew YS, Desaive T, Chase JG (2022). Model-based patient matching for in-parallel pressure-controlled ventilation. BioMedical Engineering Online. 21(1). 11-.
Keywords
parallel ventilation, co-ventilation, decision support, model-based method
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::32 - Biomedical and clinical sciences::3201 - Cardiovascular medicine and haematology::320103 - Respiratory diseases
Fields of Research::40 - Engineering::4003 - Biomedical engineering::400303 - Biomechanical engineering
Rights
© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.