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l'interaction Patient-Ventilateur: Approche technique d'une analyse biologique

Laurent Heyer 1
1 TIMC-PRETA - Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée
TIMC - Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525
Abstract : Optimal Patient/Ventilator Interactions (PVI) is a determinant factor for pressure support therapy. We studied the hybrid system {Patient, Ventilator} in order to develop a clinical tool for PVI monitoring. In the first part, we described IPV as the expression of a local communication in a biological network. PVI reflect the communication process trough the respiratory system between a biological oscillator and a mechanical oscillator. This biological approach allows application of Shannon theory for the development of a de-synchronization score and the definition of an appropriate inspiratory muscle effort detector. For this purpose, we developed an automatic non-invasive detector based on a robust muscular pressure estimates continuously assessed with the help of passive mechanical respiratory models updated cycle by cycle. In the second part, we assessed these developments in patients under pressure support ventilation. The de-synchronization score was increased as the transmission channel was altered by additional noise or as the information source, the inspiratory effort, was decreased. An automatic titration of IPV by a de-synchronization score that assess channel transmission efficiency or by an inspiratory muscle effort detector that assess message generator efficiency might be helpful for respiratory function monitoring in patients under pressure support.
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Laurent Heyer. l'interaction Patient-Ventilateur: Approche technique d'une analyse biologique. Sciences de l'ingénieur [physics]. Université Joseph-Fourier - Grenoble I, 2009. Français. ⟨tel-00574563⟩

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