SOLUNUM RAHATSIZLIĞI OLAN HASTALAR İÇİN BULANIK TABANLI TİDAL VOLÜM ALGORİTMASININ GELİŞTİRİLMESİ

Yıl 2014, Cilt: 29 Sayı: 4, 0 - , 31.12.2014

Hasan Güler , Fikret Ata

https://doi.org/10.17341/gummfd.88514

Öz

Bu çalışmanın amacı, solunum sıkıntısı çeken hastalar için yeni bir bulanık tabanlı tidal volüm algoritmasını geliştirmektir. Akut solunum sıkıntı sendromu (ASSS) gibi hastalıkların tedavisinde tidal volümün değerinin 6 ml/kg olması istenmektedir. Fakat bu tidal volüm hedefi yetersiz oksijenasyon ve ventilasyondan kaynaklanan nedenlerden dolayı sıklıkla aşılmaktadır. Bundan dolayı, tidal volümdeki aşımı önlemek amacıyla bulanık mantık tabanlı bir algoritma geliştirildi. Bulanık sistemin girişleri pozitif ekspiratuar sonu basınç (PEEP),  plato basıncı (Pplt), arterial oksijen saturasyonu (SaO₂) ve PEEP’deki değişim, çıkış ise tidal volüm olarak seçilmiştir. Geliştirilen algoritmayı test için Monte-Carlo benzetimi ve Gauss-Dağılım metodu kullanılarak 1000 adet klinik senaryo üretilmiştir. Benzetimden elde edilen sonuçlar ile senaryoya göre klinisyenin önerdiği değerleri karşılaştırmak için student t-testi (P<0.05) kullanılmıştır. Karşılaştırma sonucuna göre, iki durumdaki tidal volüm değerlerinde istatistiksel olarak bir farklılık görülmemiştir. Geliştirilen algoritmanın hastaların tedavisinde arzu edilen 6 ml/kg tidal volüm hedefi için mantıklı ve standart bir tedavi olabileceği görülmüştür.

Anahtar Kelimeler

Bulanık Mantık, Mekanik Ventilasyon, Monte-Carlo Benzetimi, Gauss-Dağılımı.

Kaynakça

• Pillbeam, S.P., Mechanical ventilation: Physiological and Clinical Application, 2nd Ed. St Louis, Mosby, 1992.
• Laubscher, T.P., Heinrichs, W., Weiler, N.,. Hartmann, G., Brunner, J.X, “An Adaptive Lung Ventilation Controller”, IEEE Transactions on Biomedical Engineering, Cilt 41, 51-58, 1994.
• Guler, H., Ata, F., “Estimation of Inspiration and Expiration Time by Using Fuzzy Control With Respect to Lung's Dynamics”, 2009 Fifth International Conference on Soft Computing, Computing with Words and Perceptions in System Analysis, Decision and Control, 91-95,2010
• Laubscher, T.P., Heinrichs, W., Weiler, N., Hartmann, G., Brunner, J.X., “The Minimal Alveolar Ventilation Controller”, Engineering in Medicine and Biology Society, Proceedings of the Annual International Conference of the IEEE, Cilt 6, 2711-2712, 1992.
• Cappa, P.,. Scuito, S.A., “Experimental Analysis of the Airway Circuit Effects on Breathing Pattern Generates by Neonatal Pulmonary Ventilators”, Proceedings-22nd International Conference-IEEE/EMBS, Cilt 4, 3132-3135, 2000.
• Rios, C.A.,. Tafur, J.C., “Mathematical Model and Control of the Pneumatic System of a Lung Ventilator Prototype” Proceedings-25th International Conference-IEEE/EMBS, Cilt 3, 2776-2779, 2003.
• Chatburn R.L., “Engineering Principles Applied to Mechanical Ventilator”, Proceedings- 25th International Conference-IEEE/EMBS, Cilt 1, 406-410, 2003.
• Guler, H., Turkoglu, I., Ata, F., “ Mechanical Ventilator Design Methods”, Erciyes University Journal of the Institute of Science and Technology, Cilt 26, Sayı 3, 248-257, 2010.
• Guler, H., Turkoglu, I., Ata, F., “Designing Intelligent Mechanical Ventilator and User Interface Using LabVIEW (R)”, Arabian Journal for Science and Engineering, Cilt 39, Sayı 6, 4805-4813, 2014
• Guler, H., Ata, F., “The Comparison of Manual and LabVIEW-Based Fuzzy Control on Mechanical Ventilation”, Proceedings of The Institution of Mechanical Engineers Part H-Journal of Engineering in Medicine, Cilt 228, Sayı 9, 916-925, 2014
• Guler, H., Ata, F., “Design of a Fuzzy-Labview-Based Mechanical Ventilator” Computer Systems Science and Engineering, Cilt 29, Sayı 3, 219-229, 2014
• Rees, S.E., Kjaergaard, S., Thorgaard, P., Toft, E., Andreassen, S., “A Physiological Model Based Approach to Medical Decision Support in the Intensive Care Unit”, Engineering in Medicine and Biology Society, Proceedings of the 25th Annual International Conference of the IEEE, Cilt 1 ,432-433, 2003.
• Stegmaier, P.A., Brunner, J.X., Tschichold, N.N., Laubscher, T.P., Liebert, W., “Fuzzy Logic Cough Detection: A First Step Towards Clinical Application”, Fuzzy Systems, IEEE World Congress on Computational Intelligence., Proceedings of the Third IEEE Conference, 1000-1005,1994
• Nemoto, T., Hatzakis, G.E., Thorpe, C.W., Olivenstein, R., Dial S., Bates, J.H.T, “Automatic Control of Pressure Support Mechanical Ventilation Using Fuzzy Logic”, American Journal Respiratory and Critical Care Medicine, Cilt160, Sayı 2, 550-556, 1999.
• Nelson, D.S., Strickland, J.H., Jannet, T.C, “Simulation of Fuzzy Control for Management of Respiratory Rate in Assist Control Mechanical Ventilaton”, Proceedings-19th International Conference-IEEE/EMBS, Cilt 3, 1104-1107, 1997.
• Kwok, H.F., Linkens, D.A., Mahfouf, M., Mill, G.H., “SIVA: Hybrid knowledge and model based advisory system for intensive care ventilators”, IEEE Transactions on Information Technology in Biomedicine, Cilt 8, Sayı 2, 161-171, 2004.
• Zhu, H., Möller, K., “Ventilator Control Based on Fuzzy-Neural Network Approach”, Bioinformatics and Biomedical Engineering, ICBBE 2008, 747-750, 2008.
• Tzavaras, A., Weller, P.R, Spyropoulos, B., “A Neuro-Fuzzy Controller for the Estimation of Tidal Volume and Respiration Frequency Ventilator Settings for COPD Patients Ventilated in Control Mode”, Proceedings of the Annual International Conference of the IEEE-EMBS, 3765-3768 , 2007.
• Kilic, Y.A., Kilic, I., “A novel Fuzzy Logic Inference System for Decision Support in Weaning from Mechanical Ventilation”, Journal of Medical Systems, Cilt 34, Sayı 6, 1089-1095, 2010.
• ARDS Network. “Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and The Acute Respiratory Distress Syndrome”, N Engl. J Med Cilt 342, 1301-1308, 2000.
• Bates, J.H.T., Guler, H., Ma, B., Allen, G.B, "A Fuzzy Logic Algorithm For Rationalized Departure From 6 ml/kg Tidal Volume When Ventilating the Injured Lung", American Thoracic Society International Conference-ATS-2011, Denver/USA, 15-17 May ,2011.
• Campoccia, A., Favuzza, S., Sanseverino, E.R., Zizzo, G., “Reliability Analysis of a Stand-Alone PV System for the Supply of a Remote Electric Load”, SPEEDAM 2010-International Symposium on Power Electronics, Electrical Drives, Automation and Motion, Italy, 2010
• Hubbard, D., “How to Measure Anything: Finding the Value of Intangibles in Business” sayfa 46, John Wiley & Sons, 2007.
• Tan, C.W., Green, T.C., Hernandez-Aramburo, C.A., “A Stochastic Simulation of Battery Sizing for Demand Shifting and Uninterruptible Power Supply Facility”, 38th IEEE Power Electronic Specialists Conferences, 2607-2613, 2007.
• Capasso, W., Grattieri. F.,, Insinga, A., Invernizzi, R., Lamedica, A., Prudenzi, A., “Validation tests and applications of a model for demand-side management studies in residential load areas”, proceedings of CIRED 2003 Conference, Birmingham, UK, 1-5, .1993.