SOLUNUM RAHATSIZLIĞI OLAN HASTALAR İÇİN BULANIK TABANLI TİDAL VOLÜM ALGORİTMASININ GELİŞTİRİLMESİ

Yıl 2014, , 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.

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