Ang, Christopher Yew Shuen and Chiew, Yeong Shiong and Wang, Xin and Ooi, Ean Hin and Mat Nor, Mohd Basri and Zhou, Cong and Chase, J. Geoffrey (2024) Comparative virtual trials pressure-controlled versus volume-controlled stochastic integrated model-based mechanical ventilation protocols. In: IFAC Symposium on Biological and Medical Systems 2024, 11-13 Sep 2024, Villingen-Schwenningen, Germany.
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Abstract
Pressure-controlled (PC) ventilation is a pressure-targeted mode of mechanical ventilation (MV) to prevent barotrauma by using pre-set driving pressures. However, the lack of clinician consensus on approaches towards pressure-targeted MV management can lead to suboptimal MV treatment and adverse patient outcomes. This study presents an in-silico trial for the validation of a pressure-based, stochastic model-integrated SiVENT protocol to guide this care. The PC SiVENT protocol uses a respiratory elastance (Ers) stochastic model and model-based methods to recommend a safe combination of MV input settings. The protocol was implemented on PC virtual patients (VP) (N=29; 2,630 hours MV data) in a virtual trial to derive protocol-suggested MV settings and resulting VP responses to these MV settings. Virtual trial outcomes were compared with the retrospective clinical data and similar volume-control (VC) SiVENT virtual trials, by assessing the compliance rate of measured VP responses to established clinical safety thresholds. Out of 29 PC VPs, 3 retrospective VPs (∼10%) and 23 SiVENT VPs (∼79%) achieve an all-compliance rate of > 80%. The results of the virtual trials demonstrate the efficacy of the SiVENT PC in regulating pressure-based MV outcomes, as well as the potential to safely streamline the development, optimisation and validation process of new MV decision support systems. The protocols presented would make measurable advances in individualised care with significant potential following improved patient outcomes in MV. The overall results justify prospective clinical trials.
| Item Type: | Proceeding Paper (Other) |
|---|---|
| Uncontrolled Keywords: | Mechanical Ventilation, Pressure control, Virtual Patient, Model-Based Protocols, Virtual Trials |
| Subjects: | R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid |
| Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Medicine Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care |
| Depositing User: | Dr. Mohd Basri Mat Nor |
| Date Deposited: | 18 Dec 2025 12:45 |
| Last Modified: | 18 Dec 2025 12:49 |
| Queue Number: | 2025-12-Q797 |
| URI: | http://irep.iium.edu.my/id/eprint/125622 |
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