title: Automatic detection of ventilatory modes during invasive mechanical ventilation.
abstract: BACKGROUND
  Expert systems can help alleviate problems related to the shortage of human resources in critical care, offering expert advice in complex situations. Expert systems use contextual information to provide advice to staff. In mechanical ventilation, it is crucial for an expert system to be able to determine the ventilatory mode in use. Different manufacturers have assigned different names to similar or even identical ventilatory modes so an expert system should be able to detect the ventilatory mode. The aim of this study is to evaluate the accuracy of an algorithm to detect the ventilatory mode in use.
  
  
  METHODS
  We compared the results of a two-step algorithm designed to identify seven ventilatory modes. The algorithm was built into a software platform (BetterCare® system, Better Care SL; Barcelona, Spain) that acquires ventilatory signals through the data port of mechanical ventilators. The sample analyzed compared data from consecutive adult patients who underwent >24 h of mechanical ventilation in intensive care units (ICUs) at two hospitals. We used Cohen's kappa statistics to analyze the agreement between the results obtained with the algorithm and those recorded by ICU staff.
  
  
  RESULTS
  We analyzed 486 records from 73 patients. The algorithm correctly labeled the ventilatory mode in 433 (89 %). We found an unweighted Cohen's kappa index of 84.5 % [CI (95 %) = (80.5 %: 88.4 %)].
  
  
  CONCLUSIONS
  The computerized algorithm can reliably identify ventilatory mode.
authors: Clínica Bazterrica y Clínica Santa Isabel, Departamento de Ciencias Fisiológicas, Farmacológicas y Bioquímicas, Facultad de Medicina, Universidad Favaloro, Buenos Aires, Argentina.
authors: Gastón
authors: G
authors: Murias
authors: CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.|Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, c. ParcTaulí 1, 08208, Sabadell, Spain.
authors: Jaume
authors: J
authors: Montanyà
authors: Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, c. ParcTaulí 1, 08208, Sabadell, Spain.
authors: Encarna
authors: E
authors: Chacón
authors: Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, c. ParcTaulí 1, 08208, Sabadell, Spain.
authors: Anna
authors: A
authors: Estruga
authors: Servei de Medicina Intensiva, Hospital Sant Joan de Deu-Fundació Althaia, Universitat Internacional de Catalunya, Manresa, Spain.
authors: Carles
authors: C
authors: Subirà
authors: CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.|Servei de Medicina Intensiva, Hospital Sant Joan de Deu-Fundació Althaia, Universitat Internacional de Catalunya, Manresa, Spain.
authors: Rafael
authors: R
authors: Fernández
authors: Better Care, Barcelona, Spain.
authors: Bernat
authors: B
authors: Sales
authors: Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, c. ParcTaulí 1, 08208, Sabadell, Spain.
authors: Candelaria
authors: C
authors: de Haro
authors: CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.|Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, c. ParcTaulí 1, 08208, Sabadell, Spain.
authors: Josefina
authors: J
authors: López-Aguilar
authors: Department of Perioperative Medicine, Intensive Care and Emergency, Cattinara Hospital, Trieste University, Trieste, Italy.
authors: Umberto
authors: U
authors: Lucangelo
authors: CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.|Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain.
authors: Jesús
authors: J
authors: Villar
authors: Department of Respiratory Care, Massachusetts General Hospital and Department of Anesthesiology, Harvard Medical School, Boston, MA, USA.
authors: Robert M
authors: RM
authors: Kacmarek
authors: CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. lblanch@tauli.cat.|Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, c. ParcTaulí 1, 08208, Sabadell, Spain. lblanch@tauli.cat.
authors: Lluís
authors: http://orcid.org/0000-0002-4158-7464
authors: L
authors: Blanch
mesh_terms: D000465:Algorithms; D001331:Automation / Q000295:instrumentation / Q000379:methods; D020000:Decision Support Systems, Clinical / Q000295:instrumentation / Q000592:standards / Q000639:trends; D004867:Equipment Design / Q000379:methods* / Q000639:trends; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods* / Q000451:nursing; D013030:Spain; D012122:Ventilators, Mechanical / Q000639:trends*; D000078329:Workforce
keywords: Automatic detection; Information systems in critical care; Mechanical ventilation; Ventilatory mode