Modeling post-operative respiratory state in coronary artery by-pass graft patients: A methodology for weaning patients from mechanical ventilation.

摘要

One of the major activities within a typical surgical intensive care unit (SICU) is the weaning of coronary artery by-pass graft, or CABG, patients from mechanical ventilation. This is the process by which the patient, after major surgery, gradually regains spontaneous respiration. During this weaning period the patient is monitored for signs of distress. Principle indicators of patient distress during the post-operative weaning period include abnormal changes in pulmonary gas exchange parameters, cardiovascular function, and respiratory performance. Critical care staff may only have a crude estimate of the exact manner in which a patient's respiratory state, as defined principally by respiratory rate and breath volume, evolves during the weaning period. Estimating future patient spontaneous respiratory state, taken together with the vast amount of information that must be monitored on these patients, can be a daunting task from the perspective of patient care management. A model is developed which estimates the future trajectory of a CABG patient's spontaneous respiratory state, enabling critical care personnel to manage more efficiently those patients in their care.