Development and evaluation of a graphical anesthesia drug display
Development and evaluation of a graphical anesthesia drug display
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DOI：
10.1097/00000542-200203000-00010
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发表时间：
2002-03-01
期刊：
影响因子：
8.8
通讯作者：
Weinger, MB
中科院分区：
文献类型：
--
作者：
Syroid, ND;Agutter, J;Weinger, MB
背景资料：可用的静脉麻醉药浓度和效果的实时显示可以显着提高术中临床决策。药代动力学模型可用于估计过去、现在和未来的药物效应部位浓度，药效学模型可用于预测药物的相关生理效应。跨学科研究团队（生物工程，建筑，麻醉学，计算机工程和认知心理学）开发了一种图形显示，显示了实时效应部位浓度，标准化为药物的EC95，静脉注射毒品创建图形隐喻是为了显示药物的药效学。为了评估显示器对全静脉麻醉管理的影响，15名麻醉师参加了一项基于计算机的模拟研究。参与者照顾病人在两个实验条件：有和没有药物显示器。结果：与药物显示器，临床医生给予更多的推注剂量的瑞芬太尼在麻醉维持。瑞芬太尼和丙泊酚的预测效应部位浓度变化显著较低，效应部位浓度保持在更接近药物的EC95。模拟患者心率和血压与实验条件无显著差异。药物展示增加了参与者的感知表现，而精神需求，努力和挫折感水平降低。在模拟后的问卷调查中，参与者认为显示器是一个有用的除了麻醉monitoring.Conclusions：药物显示改变了模拟临床实践。这些结果将为下一次设计和评估提供信息，表明这种药物数据可视化方法的前景。
Background: Usable real-time displays of intravenous anesthetic concentrations and effects could significantly enhance intraoperative clinical decision-making. Pharmacokinetic models are available to estimate past, present, and future drug effect-site concentrations, and pharmacodynamic models are available to predict the drug's associated physiologic effects.Methods: An interdisciplinary research team (bioengineering, architecture, anesthesiology, computer engineering, and cognitive psychology) developed a graphic display that presents the real-time effect-site concentrations, normalized to the drugs' EC95, of intravenous drugs. Graphical metaphors were created to show die drugs' pharmacodynamics. To evaluate the effect of the display on the management of total intravenous anesthesia, 15 anesthesiologists participated in a computer-based simulation study. The participants cared for patients during two experimental conditions: with and without the drug display.Results: With the drug display, clinicians administered more bolus doses of remifentanil during anesthesia maintenance. There was a significantly lower variation in the predicted effect-site concentrations for remifentanil and propofol, and effect-site concentrations were maintained closer to the drugs' EC95. There was no significant difference in the simulated patient heart rate and blood pressure with respect to experimental condition. The perceived performance for the participants was increased with the drug display, whereas mental demand, effort, and frustration level were reduced. In a postsimulation questionnaire, participants rated the display to be a useful addition to anesthesia monitoring.Conclusions: The drug display altered simulated clinical practice. These results, which will inform the next iteration of designs and evaluations, suggest promise for this approach to drug data visualization.