This paper presents a knowledge-based decision support system to assist mechanical ventilation in patients with the Adult Respiratory Distress Syndrome (DSSARDS). The knowledge base uses clinical algorithms developed ...
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This paper presents a knowledge-based decision support system to assist mechanical ventilation in patients with the Adult Respiratory Distress Syndrome (DSSARDS). The knowledge base uses clinical algorithms developed from interviews and seminars with experts. The system contains 140 rules, applies backward chaining and was built on an IBM-PC compatible microcomputer. Clinical and physiological data and ventilator settings were used for suggestions of ventilatory support mode (VSMODE) and settings (MVSET) and for hemodynamic evaluation and therapy (HEMO). Success rates (s) and kappa coefficient (k) were used to measure agreement between DSSARDS and physicians at 4 decision steps related to: beginning of mechanical ventilation (FIRSTSET), VSMODE, MVSET and HEMO. DSSARDS prototype was evaluated in a development phase with 6 patients aged 48.6 +/- 15.9 years. Agreement results for 142 decision steps were: FIRSTSET k = 0.90, s = 0.93;VSMODE k = 0.76, s = 0.92;HEMO k = 0.58, s = 0.70, MVSET k = 0.86, s = 0.92 (p < 0.05 for all k). Improvements in the knowledge base were performed mainly in HEMO and VSMODE modules. The subsequent test phase studied 5 patients aged 54.8 +/- 11.0 years in a total of 900 decision steps. Results were: FIRSTSET k = 0.93, s = 0.95;VSMODE k = 0.93, s = 0.96;HEMO k = 0.97, s = 0.99, MVSET k = 0.96, s = 0.97 (p < 0.05 for all k). The results indicate significant agreement between DSSARDS and physicians for all decision steps. This suggests that DSSARDS may be used as a support for decision making and a training tool for mechanical ventilation in patients with the adult respiratory distress syndrome.
Presents experimental and theoretical investigations about the effect of mode conversion on the ultrasonic total cross section of polystyrene spheres near the resonance. An ultrasonic continuous-wave was transmitted t...
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Presents experimental and theoretical investigations about the effect of mode conversion on the ultrasonic total cross section of polystyrene spheres near the resonance. An ultrasonic continuous-wave was transmitted through a random medium consisting of a suspension of polystyrene spheres (mean diameter 0.589 mm, standard deviation 0.066 mm) in a solution of water and sugar. The average total cross section of the particle distribution was obtained from measurements of the wave intensity attenuation, for frequency ranges of 0.85 to 3.0 MHz and 5.0 to 6.0 MHz, equivalent to ka ranges (k as the wave number and a as the average radius of the particles) of 1.05 to 3.71 and 6.18 to 7.41, respectively. Experimental results of the total cross section presents a resonant behavior, for ka between 1.07 to 1.38, that is demonstrated to be due to propagation of acoustic shear waves inside the particles
A microcomputer-based system for mapping the brain electrical activity after source derivation has been developed. The EEG data are obtained as a set of up to 16 unipolar derivations, sampled and displayed in real tim...
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