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Cerebral Autoregulation Monitoring and Online Arden Syntax Clinical Decision Support for the Treatment of Intracranial Hypertension in Children with Traumatic Brain Injury
Sergei B. Arseniev, Valeri G. Amcheslavsky, Valeri I. Lukianov, Irina A. Kolikhalkina, Andrea Rappelsberger, Klaus-Peter Adlassnig
Intracranial hypertension is a serious complication in the intensive care of children with severe traumatic brain injury (STBI).
Objective:
The goal was to create a computer system for simultaneous neuromonitoring of cerebral parameters and Arden-Syntax-based clinical decision support (CDS) in children with STBI undergoing intensive care treatment.
Methods:
Intensive care of these patients is based on internationally accepted guidelines. Arden Syntax, which is an HL7 medical knowledge representation and processing standard for CDS systems, was used to develop digital algorithms for these guidelines.
Results:
Comparison of a group of 37 conventionally treated patients with a second group (84 patients) monitored and treated with the combined CDS system yielded statistically significant differences.
Conclusion:
A combination of cerebral autoregulation monitoring with Arden-Syntax-based CDS in accordance with guidelines for the treatment of intracranial hypertension in children with STBI provides markedly better treatment outcomes. It opens up new options for the use of standards to formalize and process medical knowledge in neuromonitoring.
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