A Patient Simulation Model Based on Decision Tables for Emergency Shocks

Physicians in Intensive Care Units ICU have to deal with shocked patients very often. These are critical emergencies that require rapid and precise clinical reactions in order to avoid fatal organ decline and patient's death. New treatments cannot be checked directly on real patients because of the risks this could imply. For this reason several simulators have been published. These simulators use to be implemented as complex mathematical models and they are oriented to concrete types of shocks or focused on fluid resuscitation. Here, we present a new simulator which is based on decision tables. It is able to simulate the evolution of seven different sorts of shocks when treated with fluid resuscitation and vasoactive agents.

[1]  Raimund Erbel,et al.  Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. , 2004, European heart journal.

[2]  Richard N. Shiffman,et al.  Model Formulation: Representation of Clinical Practice Guidelines in Conventional and Augmented Decision Tables , 1997, J. Am. Medical Informatics Assoc..

[3]  David Riaño.  A Systematic Analysis of Medical Decisions: How to Store Knowledge and Experience in Decision Tables , 2011, KR4HC.

[4]  Aziz Sheikh,et al.  2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis , 2012, Current opinion in allergy and clinical immunology.

[5]  O. Barnea,et al.  Fluid Resuscitation: Computer Simulation and Animal Experiments , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[6]  R A Greenes,et al.  Rule set reduction using augmented decision table and semantic subsumption techniques: application to cholesterol guidelines. , 1992, Proceedings. Symposium on Computer Applications in Medical Care.

[7]  T. Gómez-Cía,et al.  A burn patient resuscitation therapy designed by computer simulation (BET). Part 1: Simulation studies. , 1993, Burns : journal of the International Society for Burn Injuries.

[8]  T. Gómez-Cía,et al.  A burn patient resuscitation therapy designed by computer simulation (BET). Part 2: Initial clinical validation. , 1993, Burns : journal of the International Society for Burn Injuries.

[9]  Judith S. Hochman,et al.  Cardiogenic Shock: Current Concepts and Improving Outcomes , 2008, Circulation.

[10]  David M Gaba,et al.  The future vision of simulation in health care , 2004, Quality and Safety in Health Care.

[11]  Jose Luis Zamorano,et al.  The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS) , 2014 .

[12]  Adam Torbicki,et al.  Management of venous thrombo-embolism: an update. , 2014, European heart journal.

[13]  J C Benneyan,et al.  An introduction to using computer simulation in healthcare: patient wait case study. , 1997, Journal of the Society for Health Systems.

[14]  Nicolas Meneveau,et al.  Erratum: 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism (European Heart Journal (2014) 35 (3033-73) DOI 10.1093/eurheartj/ehu283) , 2015 .

[15]  Mauro Ursino,et al.  Role of the Baroreflex in Cardiovascular Instability: A Modeling Study , 2001 .

[16]  T Groth,et al.  Computer simulation of fluid resuscitation in trauma. First pragmatic validation in thermal injury. , 1989, The Journal of burn care & rehabilitation.

[17]  Pieter F de Vries Robbé,et al.  Decision tables and rule engines in organ allocation systems for optimal transparency and flexibility , 2011, Transplant international : official journal of the European Society for Organ Transplantation.

[18]  T Groth,et al.  Potential use of computer simulation in treatment of burns with special regard to oedema formation. , 1984, Scandinavian journal of plastic and reconstructive surgery.

[19]  O Barnea,et al.  Myocardial O2 balance during fluid resuscitation in uncontrolled hemorrhage: computer model. , 1997, The Journal of trauma.

[20]  C. Sprung,et al.  Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock 2012 , 2013, Critical care medicine.

[21]  David Riaño,et al.  Training Residents in the Application of Clinical Guidelines for Differential Diagnosis of the Most Frequent Causes of Arterial Hypertension with Decision Tables , 2014, KR4HC@VSL.

[22]  L Levi,et al.  Hemodynamic parameters in patients with acute cervical cord trauma: description, intervention, and prediction of outcome. , 1993, Neurosurgery.

[23]  E. Ivers,et al.  Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock , 2001 .