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[计算机模拟在闭环麻醉中的有效性]

[Validity of computer simulation in closed circuit anesthesia].

作者信息

Maione M, Fabbrini G P, Grassi P, Mazzi C, Farnesi C

机构信息

Servizio di Anestesia e Rianimazione, USL n. 21 del Casentino, Ospedale Civile, Bibbiena, Arezzo.

出版信息

Minerva Anestesiol. 1993 Jan-Feb;59(1-2):29-34.

PMID:8474670
Abstract

Developing a computer program to simulate the uptake, distribution, and elimination of inhalational anesthetics allow the anesthesiologist to address specific problems, but intense skills are required to translate the involved process first into a set of mathematical equations and then into a satisfactory computer program. The first step is facilitated by solutions offered in the literature. The second step by personal computer program now currently available as Gus, this program simulates anesthetic uptake and distribution using a numerical model with 12 compartments. Transport of anesthetic agents among the compartment occurs via convection of gas and blood during discrete iteration of the simulation. As initial clinical validation of the linear 12 compartment basic model the current study examined the predictive performance in 20 patients by comparing quantitatively the predicted and the measured alveolar concentration-time profiles after achievement of end tidal concentration of isoflurane (C-alv%) injected into a heated chamber (75 degrees) and then transported in closed circuit system during mechanical ventilation. With regard to the use of isoflurane 20 patients were adequately anesthetized with only 88 ml of liquid isoflurane and that is the same in simulation achieved by computer.

摘要

开发一个计算机程序来模拟吸入麻醉剂的摄取、分布和消除,使麻醉医生能够解决特定问题,但需要高超的技能才能首先将相关过程转化为一组数学方程,然后转化为一个令人满意的计算机程序。第一步可借助文献中提供的解决方案。第二步借助目前作为Gus提供的个人计算机程序,该程序使用具有12个隔室的数值模型模拟麻醉剂的摄取和分布。在模拟的离散迭代过程中,麻醉剂在隔室之间的传输通过气体和血液的对流进行。作为对线性12隔室基本模型的初步临床验证,本研究通过定量比较在达到注入加热室(75度)然后在机械通气期间在闭路系统中传输的异氟烷呼气末浓度(C-alv%)后预测的和测量的肺泡浓度-时间曲线,检查了20名患者的预测性能。关于异氟烷的使用,仅用88毫升液体异氟烷就使20名患者得到充分麻醉,这与计算机模拟的结果相同。

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