Rudge A D, Chase J G, Shaw G M, Lee D
Centre for Bioengineering, Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, New Zealand.
Med Eng Phys. 2006 Jan;28(1):49-59. doi: 10.1016/j.medengphy.2005.03.005.
Agitation-sedation cycling in critically ill patients, characterized by oscillations between states of agitation and over-sedation, damages patient health and increases length of stay and cost. A model that captures the essential dynamics of the agitation-sedation system and is physiologically representative is developed, and validated using data from 37 critical care patients. It is more physiologically representative than a previously published agitation-sedation model, and captures more realistic and complex dynamics. The median time in the 90% probability band is 90%, and the total drug dose, relative to recorded drug dose data, is a near ideal 101%. These statistical model validation metrics are 5-13% better than a previously validated model. Hence, this research provides a platform to develop and test semi-automated sedation management controllers that offer the significant clinical potential of improved agitation management and reduced length of stay in critical care.
危重症患者的激越-镇静循环，其特征为激越状态与过度镇静状态之间的波动，会损害患者健康并增加住院时间和费用。开发了一个捕捉激越-镇静系统基本动态且具有生理代表性的模型，并使用来自37名重症监护患者的数据进行了验证。它比之前发表的激越-镇静模型更具生理代表性，且捕捉到了更现实、更复杂的动态。在90%概率区间内的中位时间为90%，相对于记录的药物剂量数据，总药物剂量近乎理想地达到了101%。这些统计模型验证指标比之前验证的模型高出5%-13%。因此，本研究提供了一个平台，用于开发和测试半自动镇静管理控制器，这些控制器在改善激越管理和缩短重症监护住院时间方面具有显著的临床潜力。
