Florida Anesthesia Computer and Engineering Team
©
University of Florida, 1996
Even though computers are used extensively in clinical practice, there is still much room for improvement; still needed are ways to integrate information from multiple monitoring signals, to integrate information from intraoperative monitoring with preoperative assessment or other clinical work-up, and to provide the anesthesiologist with help making the differential diagnosis when problems arise. Alarm technology and artifact rejection are other areas currently under intensive investigation. Both voice and handwriting recognition are promising technologies that could be used, for example, to enter notes and drug information into the anesthesia record.
Artificial intelligence (AI) applications in medicine have been developed to assist the clinician primarily in the area of consultation. The pioneer of these systems is MYCIN, a program that provides advice for the diagnosis and treatment of sepsis and meningitis. "Attending" is a computer program that offers a critique of anesthesia plans proposed by a clinician based upon a consultant's opinion. Intraoperative applications of computers include the automated detection of breathing system malfunctions, such as leaks, obstructions, or incompetent valves. A computer can monitor pressure, flow, and PCO2 in the system and recognize if patterns of these variables suggest a failure in the anesthesia circle. Another application for computers is rapid, repeated calculations. For example, the moment-by-moment concentration of carbon dioxide in a Mapleson breathing system can be determined by a computer model that defines the components of the system in mathematical terms. For a breathing system this would include the volume, the resistance, and the compliance of the tubing. It is also possible to model the cardiovascular system and calculate hemodynamic variables on a moment-to-moment basis. Modeling is now used extensively in the development of training devices and simulators, which are covered in the next section. For intraoperative management, computer-based models will become indispensable.
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