A physiology simulator: validation of its respiratory components and its ability to predict the patient's response to changes in mechanical ventilation
A physiology simulator: validation of its respiratory components and its ability to predict the patient's response to changes in mechanical ventilation
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DOI：
10.1093/bja/81.3.327
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发表时间：
1998-09-01
影响因子：
9.8
通讯作者：
Aitkenhead, AR
中科院分区：
文献类型：
--
作者：
Hardman, JG;Bedforth, NM;Aitkenhead, AR
我们的目的是验证诺丁汉生理模拟器（NPS）呼吸组件的数学有效性和准确性，这是一种生理模型的计算机模拟。随后，我们旨在评估NPS在预测机械通气改变对患者动脉血气张力影响方面的准确性。NPS提供了接受强化治疗的患者的以下测量或计算值：肺分流和生理死亡空间分数、耗氧量、呼吸商、心输出量、吸入氧分数、过期分钟体积、血红蛋白浓度、温度和动脉碱过量。NPS计算的动脉氧张力和饱和度（Pa-O2和Sa(O2)）、混合静脉氧张力和饱和度(P (V) over bar（O2）和S （V) over bar(O2)）、动脉和混合静脉二氧化碳张力(Pa-CO2和P （V) over bar(CO2)）和动脉pH值与实测值相比准确。随后，测量31例患者的动脉气体对分气量或FIO2变化的反应，并与NPS预测的每种反应进行比较。预测变化幅度的95%一致性限为：动脉氧张力-2.07 ~ 2.47 kPa；Pa-CO2 -0.33 ~ 0.67 kPa；pH值-0.023 ~ 0.033。这项调查证实了NPS的呼吸成分。我们推荐NPS作为预测重症监护病房稳定患者机械通气改变效果的临床工具。
We aimed to validate the mathematical validity and accuracy of the respiratory components of the Nottingham Physiology Simulator (NPS), a computer simulation of physiological models. Subsequently, we aimed to assess the accuracy of the NPS in predicting the effects of a change in mechanical ventilation on patient arterial blood-gas tensions. The NPS was supplied with the following measured or calculated values from patients receiving intensive therapy: pulmonary shunt and physiological deadspace fractions, oxygen consumption, respiratory quotient, cardiac output, inspired oxygen fraction, expired minute volume, haemoglobin concentration, temperature and arterial base excess. Values calculated by the NPS for arterial oxygen tension and saturation (Pa-O2 and Sa(O2)), mixed venous oxygen tension and saturation (P (V) over bar(O2) and S (V) over bar(O2)), arterial and mixed venous carbon dioxide tension (Pa-CO2 and P (V) over bar(CO2)) and arterial pH were accurate compared with measured values. Subsequently, arterial gas responses to changes in minute volume or FIO2 were measured in 31 patients and were compared with the NPS prediction for each response. The 95% limits of agreement in predicting the magnitude of change were: arterial oxygen tension -2.07 to 2.47 kPa; Pa-CO2 -0.33 to 0.67 kPa; and pH -0.023 to 0.033. This Investigation has validated respiratory components of the NPS. We recommend the NPS as a clinical tool for predicting the effects of alterations in mechanical ventilation in stable patients in the intensive care unit.