Model-based decision support system for individual prescription of the dialysate bicarbonate concentration in hemodialysis.
A decision support system has been developed that determines the optimal dialysate bicarbonate concentration in hemodialysis therapy for each patient individually. The knowledge about the behavior of the acid-base state during treatment has been provided by a mathematical model for the description of dynamic exchange processes during hemodialysis. This model simulates the sodium and water distribution, the acid-base state as well as the ventilation. The decision support system uses the model for the prediction of the end-dialysis acid-base state and calculates by means of linear optimization the dialysate bicarbonate concentration which is necessary to reach a specified end-dialysis state. If the aspired acid-base state can not be reached, the system varies the dialysate sodium concentration and the treatment time. The whole program can be used on a PC and is easy to use. One decision making process lasts between 10 seconds and 5 minutes depending on the computer.
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Institute of Physiology and Pathophysiology, Johannes Gutenberg-Universität, Mainz, Germany.
D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D001639:Bicarbonates; D003198:Computer Simulation; D003661:Decision Support Techniques; D015314:Dialysis Solutions; D006801:Humans; D008875:Middle Aged; D008954:Models, Biological; D006435:Renal Dialysis / Q000379:methods; D012964:Sodium
D001639:Bicarbonates; D015314:Dialysis Solutions; D012964:Sodium