tailieunhanh - Chase et al. Annals of Intensive Care 2011, 1:11

Chase et al. Annals of Intensive Care 2011, 1:11 REVIEW Open Access Physiological modeling, tight glycemic control, and the ICU clinician: what are models and how can they affect practice? J Geoffrey Chase1*, Aaron J Le Compte1, J-C Preiser2, Geoffrey M Shaw3, Sophie Penning4 and Thomas Desaive4* Abstract Critically ill patients are highly variable in their response to care and treatment. This variability and the search for improved outcomes have led to a significant increase in the use of protocolized care to reduce variability in care. However, protocolized care does not address the variability of outcome due to inter- and intra-patient variability, both in. | Chase et al. Annals of Intensive Care 2011 1 11 http content 1 1 11 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Physiological modeling tight glycemic control and the ICU clinician what are models and how can they affect practice J Geoffrey Chase1 Aaron J Le Compte1 J-C Preiser2 Geoffrey M Shaw3 Sophie Penning4 and Thomas Desaive4 Abstract Critically ill patients are highly variable in their response to care and treatment. This variability and the search for improved outcomes have led to a significant increase in the use of protocolized care to reduce variability in care. However protocolized care does not address the variability of outcome due to inter- and intra-patient variability both in physiological state and the response to disease and treatment. This lack of patient-specificity defines the opportunity for patient-specific approaches to diagnosis care and patient management which are complementary to and fit within protocolized approaches. Computational models of human physiology offer the potential with clinical data to create patient-specific models that capture a patient s physiological status. Such models can provide new insights into patient condition by turning a series of sometimes confusing clinical data into a clear physiological picture. More directly they can track patient-specific conditions and thus provide new means of diagnosis and opportunities for optimising therapy. This article presents the concept of model-based therapeutics the use of computational models in clinical medicine and critical care in specific as well as its potential clinical advantages in a format designed for the clinical perspective. The review is presented in terms of a series of questions and answers. These aspects directly address questions concerning what makes a model how it is made patient-specific what it can be used for its limitations and importantly what constitutes sufficient validation. To provide a .