Retrospective evaluation of a decision support system for controlled mechanical ventilation
Related Experiment Video
Updated: May 27, 2026

Mechanical Ventilation Boot Camp Curriculum
Published on: March 12, 2018
Dan S Karbing1, Charlotte Allerød, Lars P Thomsen
1Center for Model-based Medical Decision Support, Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark. dank@hst.aau.dk
Abstract:
Management of mechanical ventilation in intensive care patients is complicated by conflicting clinical goals. Decision support systems (DSS) may support clinicians in finding the correct balance. The objective of this study was to evaluate a computerized model-based DSS for its advice on inspired oxygen fraction, tidal volume and respiratory frequency. The DSS was retrospectively evaluated in 16 intensive care patient cases, with physiological models fitted to the retrospective data and then used to simulate patient response to changes in therapy. Sensitivity of the DSS's advice to variations in cardiac output (CO) was evaluated. Compared to the baseline ventilator settings set as part of routine clinical care, the system suggested lower tidal volumes and inspired oxygen fraction, but higher frequency, with all suggestions and the model simulated outcome comparing well with the respiratory goals of the Acute Respiratory Distress Syndrome Network from 2000. Changes in advice with CO variation of about 20% were negligible except in cases of high oxygen consumption. Results suggest that the DSS provides clinically relevant and rational advice on therapy in agreement with current 'best practice', and that the advice is robust to variation in CO.
Related Concept Videos
Mechanical Ventilation I: Indication and Settings
Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...