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SOLUNUM RAHATSIZLIĞI OLAN HASTALAR İÇİN BULANIK TABANLI TİDAL VOLÜM ALGORİTMASININ GELİŞTİRİLMESİ

DEVELOPMENT OF A FUZZY-BASED TIDAL VOLUME ALGORITHM FOR PATIENTS WITH RESPIRATORY DISTRESS

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Abstract (2. Language): 
The purpose of the present study is to develop a fuzzy-based tidal volume algorithm for patients with respiratory distress. The standard of care when ventilating patients with the acute respiratory distress syndrome is to use a tidal volume of 6 ml/kg for ideal body weight. But, this tidal volume aim is frequently exceeded for many reasons, most typically related to physician discomfort with clinical parameters of inadequate oxygenation and ventilation. Thus, an algorithm based on fuzzy logic has been developed in Matlab to prevent deviation in tidal volume. The inputs of fuzzy were positive end-expiratory pressure (PEEP), plateau pressure (Pplt) and arterial oxygen saturation (SaO2) and the change of PEEP. Random clinical scenarios were generated via using Monte- Carlo simulation and Gaussian distribution methods. The student t-test for p <0.05 was used to compare the obtained results from simulations and clinicians’ decision. It was found that there is no statistical discrepancy in the value of tidal volume. It can be said that this algorithm may prove useful as means of rationalizing and standardizing departures from desired 6 ml/kg tidal volume in any given patient.
Abstract (Original Language): 
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.
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706

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