Jalali Ali, Rehman Mohamed, Lingappan Arul, Nataraj C
Department of Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104;
Endowed Chair, Biomedical Informatics and Entrepreneurial Sciences Professor, Clinical Anesthesiology and Critical Care and Pediatrics Director, Biomedical Informatics Children's Hospital of Philadelphia, Philadelphia, PA 19104.
J Dyn Syst Meas Control. 2016 Nov;138(11):1110131-1110138. doi: 10.1115/1.4033864. Epub 2016 Aug 9.
This paper is concerned with the mathematical modeling and detection of endotracheal (ET) intubation in children under general anesthesia during surgery. In major pediatric surgeries, the airway is often secured with an endotracheal tube (ETT) followed by initiation of mechanical ventilation. Clinicians utilize auscultation of breath sounds and capnography to verify correct ETT placement. However, anesthesia providers often delay timely charting of ET intubation. This latency in event documentation results in decreased efficacy of clinical decision support systems. In order to target this problem, we collected real inpatient data and designed an algorithm to accurately detect the intubation time within the clinically valid range; the results show that we are able to achieve high accuracy in more than 96% of the cases. Automatic detection of ET intubation time would thus enhance better real-time data capture to support future improvement in clinical decision support systems.
本文关注的是手术期间全身麻醉下儿童气管插管的数学建模与检测。在大型儿科手术中,气道通常通过气管内导管(ETT)固定,随后开始机械通气。临床医生利用呼吸音听诊和二氧化碳描记法来验证ETT的正确放置。然而,麻醉提供者常常延迟对气管插管进行及时记录。事件记录中的这种延迟导致临床决策支持系统的效能降低。为了解决这个问题,我们收集了真实的住院患者数据,并设计了一种算法来在临床有效范围内准确检测插管时间;结果表明,在超过96%的病例中我们能够实现高精度。因此,自动检测气管插管时间将有助于更好地进行实时数据采集,以支持未来临床决策支持系统的改进。