British Journal of Anaesthesia, Vol 81, Issue 3 327-332, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
J. G. Hardman, N. M. Bedforth, A. B. Ahmed, R. P. Mahajan and A. R. Aitkenhead
We aimed to validate the mathematical validity and accuracy of the
respiratory components of the Nottingham Physiology Simulator (NPS), a
computer simulation of physiological models. Subsequently, we aimed to
assess the accuracy of the NPS in predicting the effects of a change in
mechanical ventilation on patient arterial blood-gas tensions. The NPS was
supplied with the following measured or calculated values from patients
receiving intensive therapy: pulmonary shunt and physiological deadspace
fractions, oxygen consumption, respiratory quotient, cardiac output,
inspired oxygen fraction, expired minute volume, haemoglobin concentration,
temperature and arterial base excess. Values calculated by the NPS for
arterial oxygen tension and saturation (PaO2 and SaO2), mixed venous oxygen
tension and saturation (PvO2 and SvO2), arterial and mixed venous carbon
dioxide tension (PaCO2 and PvCO2) and arterial pH were accurate compared
with measured values. Subsequently, arterial gas responses to changes in
minute volume of FiO2 were measured in 31 patients and were compared with
the NPS prediction for each response. The 95% limits of agreement in
predicting the magnitude of change were: arterial oxygen tension -2.07 to
2.47 kPa; PaCO2 -0.33 to 0.67 kPa; and pH -0.023 to 0.033. This
investigation has validated respiratory components of the NPS. We recommend
the NPS as a clinical tool for predicting the effects of alterations in
mechanical ventilation in stable patients in the intensive care unit.
CLINICAL INVESTIGATIONS
A physiology simulator: validation of its respiratory components and its ability to predict the patient's response to changes in mechanical ventilation
University Department of Anaesthesia, University Hospital, Nottingham NG7 2UH; Department of Anaesthesia, City Hospital, Nottingham NG5 2PB
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