Loeb R G, Brunner J X, Westenskow D R, Feldman B, Pace N L
Department of Anesthesiology, University of Utah, Salt Lake City.
Anesthesiology. 1989 Jun;70(6):999-1007. doi: 10.1097/00000542-198906000-00020.
A prototype anesthesia workstation has been developed to demonstrate the feasibility of a computer-assisted anesthesia workplace. The workstation provides a central display of information and aids the user in controlling and monitoring the anesthesia delivery system. The anesthesiologist interacts with the workstation through a Macintosh computer, which is easy for the clinician to understand and to use. Seventeen sensors and monitors transmit information from the anesthesia delivery system to the computer. The computer monitors this information using a set of rules, evaluated once each breath, to detect changes in the delivery system. If an event is detected, the computer alerts the anesthesiologist with a diagram, a text message, and an audible warning. A laboratory test of the monitoring system was performed to see if it properly identified 26 different critical events during simulated low flow and closed circuit anesthesia. Five hundred and eight-three of 660 simulated critical events (88%) were identified with the unique and correct message. On 35 occasions, multiple messages were displayed, including the correct one. Critical events were misidentified or not detected 42 times. Eight false positive alarms occurred during the 20 h of testing; all occurred as a result of baseline drift in a single transducer. These results demonstrate that a sophisticated monitoring system can reliably diagnose specific anesthesia machine failures.
已开发出一种原型麻醉工作站,以证明计算机辅助麻醉工作场所的可行性。该工作站提供信息的中央显示,并帮助用户控制和监测麻醉输送系统。麻醉医生通过Macintosh计算机与工作站交互,临床医生很容易理解和使用该计算机。17个传感器和监测器将麻醉输送系统的信息传输到计算机。计算机使用一组规则来监测此信息,每次呼吸评估一次,以检测输送系统的变化。如果检测到事件,计算机将通过图表、文本消息和声音警报提醒麻醉医生。对监测系统进行了实验室测试,以查看它在模拟低流量和闭路麻醉期间是否能正确识别26种不同的关键事件。660次模拟关键事件中有583次(88%)被识别并给出了独特且正确的消息。有35次显示了多条消息,包括正确的消息。关键事件被错误识别或未被检测到42次。在20小时的测试过程中出现了8次误报;所有误报都是由单个传感器的基线漂移导致的。这些结果表明,一个复杂的监测系统能够可靠地诊断特定的麻醉机故障。