Development of a decision support system to assist anesthesiologists in operating room.
The complexity of modern anesthesia procedures requires the development of decision-support systems functioning in a smart-alarm capacity. We developed computer algorithms to detect critical conditions during surgery (light anesthesia or unstable blood pressure), based on computerized anesthesia records containing hemodynamic data (heart rate, mean arterial pressure and systolic arterial pressure). Our analysis indicated that a > or = 12% change in mean arterial blood pressure (MAP), compared with the median value of MAP over the preceding 10-min interval, may be chosen as the criterion for detecting LA, with a sensitivity of 96% and a specificity of 91%. The best agreement between human and computer ratings of blood pressure lability (correlation coefficient 0.78) was achieved when we used the absolute value of the fractional change of the mean arterial pressure (magnitude of FCM) between one 2-min epoch and the next 2-min epoch. Work is under progress to develop a decision-support system to alert clinicians in the operating room environment to critical events.
Krol
M
M
Department of Anesthesiology, Mount Sinai-School of Medicine, New York, New York 10029, USA.
Reich
D L
DL
D000465:Algorithms; D000768:Anesthesia, General / Q000295:instrumentation / Q000379:methods; D000776:Anesthesiology; D019540:Area Under Curve; D001794:Blood Pressure / Q000502:physiology; D003199:Computer Systems; D003661:Decision Support Techniques; D004868:Equipment Failure; D006339:Heart Rate / Q000502:physiology; D006751:Hospital Information Systems; D006801:Humans; D016018:Least-Squares Analysis; D008991:Monitoring, Physiologic; D009873:Operating Rooms; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013599:Systole