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Title:	Automatic detection of ventilatory modes during invasive mechanical ventilation
Author:	Murias, Gastón; Montanyà, Jaume; Chacón, Encarna; Estruga, Anna; Subirà Cuyàs, Carles; Fernández Fernández, Rafael; Sales, Bernat; De Haro, Candelaria; López-Aguilar, Josefina; Lucangelo, Umberto; Villar, Jesús; Kacmarek, Robert M.; Blanch, Lluís
Notes:	Background: Expert systems can help alleviate problems related to the shortage of human resources in critical care, offering expert advice in complex situations. Expert systems use contextual information to provide advice to staff. In mechanical ventilation, it is crucial for an expert system to be able to determine the ventilatory mode in use. Different manufacturers have assigned different names to similar or even identical ventilatory modes so an expert system should be able to detect the ventilatory mode. The aim of this study is to evaluate the accuracy of an algorithm to detect the ventilatory mode in use. Methods: We compared the results of a two-step algorithm designed to identify seven ventilatory modes. The algorithm was built into a software platform (BetterCare® system, Better Care SL; Barcelona, Spain) that acquires ventilatory signals through the data port of mechanical ventilators. The sample analyzed compared data from consecutive adult patients who underwent >24 h of mechanical ventilation in intensive care units (ICUs) at two hospitals. We used Cohen’s kappa statistics to analyze the agreement between the results obtained with the algorithm and those recorded by ICU staff. Results: We analyzed 486 records from 73 patients. The algorithm correctly labeled the ventilatory mode in 433 (89 %). We found an unweighted Cohen’s kappa index of 84.5 % [CI (95 %) = (80.5 %: 88.4 %)]. Conclusions: The computerized algorithm can reliably identify ventilatory mode.
Subject(s):	-Respiració artificial -Assistència mèdica -Pacients -Algoritmes -Respiración artificial -Asistencia médica -Enfermos -Algoritmos -Mechanical ventilation (Therapy) -Medical care -Algorithms -Patients -61
Rights:	This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. http://creativecommons.org/licenses/by/4.0/
Document type:	Article Article - Accepted version
Published by:	Springer Nature
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