SBIR Phase II: A Clinical Decision Support System for Fluid Resuscitation of Intensive Care Unit Patients

这项小企业创新研究（SBIR）第二阶段项目的更广泛影响/商业潜力涉及解决流体管理的复杂性，这是重症监护中最重要的问题之一。不理想的液体管理导致许多并发症，如肺水肿。研究表明，体液超载与较高的发病率和死亡率有关。最近的研究还表明，限制性液体复苏方案可减少机械通气天数和住院时间。临床文献提供了充分的证据，证明优化的液体疗法对不同的患者群体有好处，包括败血症患者和术后患者。然而，液体疗法的实施是高度主观的。具体来说，最关键的未解决的问题包括输注液体的时间和体积。这个小企业创新研究二期项目建议开发一个系统，该系统使用标准重症监护病房血液动力学监测设备的连续测量，为临床医生提供可操作的反馈，以优化液体和血管活性药物管理。在第二阶段的工作中，我们将进一步开发第一阶段开发的临床决策支持系统，包括进一步开发基础技术和进行初步临床研究。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase II project involves addressing complexities in fluid management, one of the most important issues in critical care. Suboptimal fluid management results in many complications such as pulmonary edema. Studies show that fluid overload is associated with higher rates of morbidity and mortality. Recent studies also show that restrictive fluid resuscitation protocols result in a reduction of mechanical ventilation days and hospital length of stay. The clinical literature provides ample evidence of optimized fluid therapy benefits for different patient populations including those with sepsis and post-operative patients. However, implementation of fluid therapy is highly subjective. Specifically, the most critical unanswered questions involve the timing and the volume of fluid infusions.This Small Business Innovation Research Phase II project proposes to develop a system which uses continuous measurements from a standard intensive care unit hemodynamic monitoring device to provide actionable feedback for clinicians to optimize fluid and vasoactive drug management. In the proposed Phase II work, we will further develop the clinical decision support system developed in Phase I. This includes further development of the underlying technology and also performing preliminary clinical studies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.