Prospective evaluation of a decision support system for setting inspired oxygen in intensive care patients.
OBJECTIVE
The aim of the study was to prospectively evaluate a decision support system for its ability to provide appropriate suggestions of inspired oxygen fraction in intensive care patients comparing with levels used by clinicians in attendance.


METHODS
Thirteen mechanically ventilated patients were studied in an intensive care unit where up to 4 experiments were performed during 2 consecutive days. Inspired oxygen fraction was selected in each experiment by both the decision support system and attending clinicians, and each selection was evaluated by measuring arterial oxygen saturation.


RESULTS
Median (interquartile range [range]) changes in inspired oxygen fraction from baseline level by attending clinicians and the decision support system were 0.00 (-0.05 to 0.00 [-0.10 to 0.05]) and -0.03 (-0.07 to 0.01 [-0.16 to 0.12]), respectively. Clinician ranges of inspired oxygen fraction and arterial oxygen saturation were 0.25 to 0.70 and 0.92 to 0.99, respectively. Decision support system ranges of inspired oxygen fraction and arterial oxygen saturation were 0.26 to 0.54 and 0.94 to 0.99, respectively.


CONCLUSIONS
The decision support system selects appropriate levels of inspired oxygen fraction in intensive care patients and could be used for automatic frequent assessment of patients, freeing the focus of clinicians to concentrate on more challenging therapy.
Karbing
Dan S
DS
Center for Model-based Medical Decision Support, Department of Health Science and Technology, Aalborg University, DK-9220 Aalborg East, Denmark. dank@hst.aau.dk
Allerød
Charlotte
C
Thorgaard
Per
P
Carius
Ann-Maj
AM
Frilev
Lotte
L
Andreassen
Steen
S
Kjaergaard
Søren
S
Rees
Stephen E
SE
D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods*; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012121:Respiration, Artificial
D010100:Oxygen