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Theory and algorithms for image reconstruction on chords and within regions of interest.

We introduce a formula for image reconstruction on a chord of a general source trajectory. We subsequently develop three algorithms for exact image reconstruction on a chord from data acquired with the general trajectory. Interestingly, two of the developed algorithms can accommodate data containing transverse truncations. The widely used helical trajectory and other trajectories discussed in literature can be interpreted as special cases of the general trajectory, and the developed theory and algorithms are thus directly applicable to reconstructing images exactly from data acquired with these trajectories. For instance, chords on a helical trajectory are equivalent to the n-PI-line segments. In this situation, the proposed algorithms become the algorithms that we proposed previously for image reconstruction on PI-line segments. We have performed preliminary numerical studies, which include the study on image reconstruction on chords of two-circle trajectory, which is nonsmooth, and on n-PI lines of a helical trajectory, which is smooth. Quantitative results of these studies verify and demonstrate the proposed theory and algorithms.

Algorithms↗

Evaluation of capnography using a genetic algorithm to predict PaCO2.

INTRODUCTION: Noninvasive estimates of Paco(2) are usually done by measuring exhaled carbon dioxide at end-expiration (Petco(2)). While commonly used in studies involving healthy patients, it is less useful in sicker patients. Conditions that affect the terminal dead space and hence the accuracy of Petco(2) as a surrogate for Paco(2) may also affect other components of the capnogram. A genetic algorithm is a computer technique for discovering relationships between variables. The purpose of this study was to use a genetic algorithm to improve the precision of Paco(2) prediction in comparison to Petco(2). METHODS: Inspiratory and expiratory volumes were measured and analyzed by the computerized capnogram. Data were recorded for 2 min. Within 5 min of recording the capnograms, arterial blood gases were obtained. After excluding artifact and incomplete capnograms, five of the remaining breaths from each patient were selected. A genetic algorithm, constructed in postfix notation, consisted of 1,000 chromosomes with genes randomly selected from the 11 capnographic data fields and mathematical operators. The algorithm was constructed on 400 breaths from 83 randomly selected patients (construction group) and tested on 160 breaths from the remaining 32 patients (test group). RESULTS: For the construction group, the bias and precision between Petco(2) and Paco(2) were 4.3 +/- 4.9 mm Hg (mean +/- SD). For the 160 breaths in the test group, Petco(2) predicted Paco(2) with bias and precision of 2.9 +/- 4.2 mm Hg. The best chromosome found by the genetic algorithm was (10 x 5 + 5 x 5 x 5)/(10 x 10) x Petco(2) - (5 x 5 x 10 + 5 x 5)/(10 x 10) x int time + 2 x 2 x 2 x 2 + (2 x 2)/10, which reduces to 0.65 x Petco(2) - 2.75 x int time + 16.4. This produced a bias and precision of 0.9 +/- 4.1 mm Hg in the construction group and 0 +/- 3.7 mm Hg in the test group (p < 0.01). CONCLUSIONS: In this study of nonintubated emergency department patients, a genetic algorithm produced an improvement in bias and precision of Paco(2) prediction.

Adult↗

A fast algorithm for functional mapping of complex traits.

By integrating the underlying developmental mechanisms for the phenotypic formation of traits into a mapping framework, functional mapping has emerged as an important statistical approach for mapping complex traits. In this note, we explore the feasibility of using the simplex algorithm as an alternative to solve the mixture-based likelihood for functional mapping of complex traits. The results from the simplex algorithm are consistent with those from the traditional EM algorithm, but the simplex algorithm has considerably reduced computational times. Moreover, because of its nonderivative nature and easy implementation with current software, the simplex algorithm enjoys an advantage over the EM algorithm in the dynamic modeling and analysis of complex traits.

Algorithms↗

The value of care algorithms.

The use of protocols or care algorithms in medical facilities has increased in the managed care environment. The definition and application of care algorithms, with a particular focus on the treatment of acute bronchospasm, are explored in this review. The benefits and goals of using protocols, especially in the treatment of asthma, to standardize patient care based on clinical guidelines and evidence-based medicine are explained. Ideally, evidence-based protocols should translate research findings into best medical practices that would serve to better educate patients and their medical providers who are administering these protocols. Protocols should include evaluation components that can monitor, through some mechanism of quality assurance, the success and failure of the instrument so that modifications can be made as necessary. The development and design of an asthma care algorithm can be accomplished by using a four-phase approach: phase 1, identifying demographics, outcomes, and measurement tools; phase 2, reviewing, negotiating, and standardizing best practice; phase 3, testing and implementing the instrument and collecting data; and phase 4, analyzing the data and identifying areas of improvement and future research. The experiences of one medical institution that implemented an asthma care algorithm in the treatment of pediatric asthma are described. Their care algorithms served as tools for decision makers to provide optimal asthma treatment in children. In addition, the studies that used the asthma care algorithm to determine the efficacy and safety of ipratropium bromide and levalbuterol in children with asthma are described.

Algorithms↗

Evaluation of electrocardiographic algorithms in the assessment of the infarct-related artery in acute myocardial infarction.

OBJECTIVES: In acute myocardial infarction, it is of great value to identify the infarct-related artery and the site of occlusion in a coronary artery (proximal versus distal). This study assessed the diagnostic value of two previously published electrocardiographic algorithms to identify the infarct-related artery and the site of occlusion in anterior and inferior acute myocardial infarction. METHODS AND RESULTS: We studied retrospectively a group of 88 patients with a first myocardial infarction. We determined the infarct-related artery using the electrocardiographic algorithms on the electrocardiogram at the time of admission and compared these results with the angiographically determined infarct-related artery. The best electrocardiographic algorithm could determine the infarct-related artery in an inferior myocardial infarction as the left circumflex coronary artery and as the proximal and distal right coronary artery with a sensitivity of 63%, 67% and 80%, respectively, and a specificity of 100%, 82% and 69%, respectively. One algorithm was unable to diagnose a left circumflex coronary artery occlusion. In an anterior myocardial infarction the best electrocardiographic algorithm could determine the infarct-related artery as the proximal and distal left anterior descending coronary artery with a sensitivity of 85% and 80%, respectively, and with a specificity of 77% and 82%, respectively. CONCLUSION: In acute myocardial infarction the use of electrocardiographic algorithms is helpful to predict the site of occlusion and can play a crucial role in the care of patients.

Aged↗

Routine use of a higher order interpolator and bone algorithm in thoracic CT.

OBJECTIVE: This study was designed to evaluate the utility of the routine use of high spatial frequency algorithms and higher order helical interpolators for imaging lung parenchyma during routine thoracic CT. SUBJECTS AND METHODS: We evaluated 50 consecutive patients undergoing clinically indicated thoracic CT using the same imaging parameters and scanner. The helical volume was reconstructed three separate times using standard and higher order (180 degrees linear with double-sided lobes) interpolators and standard and high spatial frequency (bone) algorithms. The images were photographed and given to five separate readers who were kept unaware of the interpolator and algorithm and who were asked to evaluate simultaneously each patient's three sets of images for best, in-between, and worst images of the lung interstitium, pathology, and normal anatomy. RESULTS: All five readers rated the standard interpolator and algorithm images as the worst (p < .01). All five readers consistently rated the double-sided lobe interpolator and bone algorithm images as the best (p < .01). CONCLUSION: A second reconstruction of routine thoracic helical CT data using higher order helical interpolators and a bone algorithm significantly improves interstitial detail of lung parenchyma and overall visualization of normal anatomy and pathologic processes.

Aged↗

Comparing the performance of mammographic enhancement algorithms: a preference study.

OBJECTIVE: The objective of this study was to compare the performance of four image enhancement algorithms on secondarily digitized (i.e., digitized from film) mammograms containing masses and microcalcifications of known pathology in a clinical soft-copy display setting. MATERIALS AND METHODS: Four different image processing algorithms (adaptive unsharp masking, contrast-limited adaptive histogram equalization, adaptive neighborhood contrast enhancement, and wavelet-based enhancement) were applied to one image of secondarily digitized mammograms of forty cases (10 each of benign and malignant masses and 10 each of benign and malignant microcalcifications). The four enhanced images and the one unenhanced image were displayed randomly across three high-resolution monitors. Four expert mammographers ranked the unenhanced and the four enhanced images from 1 (best) to 5 (worst). RESULTS: For microcalcifications, the adaptive neighborhood contrast enhancement algorithm was the most preferred in 49% of the interpretations, the wavelet-based enhancement in 28%, and the unenhanced image in 13%. For masses, the unenhanced image was the most preferred in 58% of cases, followed by the unsharp masking algorithm (28%). CONCLUSION: Appropriate image enhancement improves the visibility of microcalcifications. Among the different algorithms, the adaptive neighborhood contrast enhancement algorithm was preferred most often. For masses, no significant improvement was observed with any of these image processing approaches compared with the unenhanced image. Different image processing approaches may need to be used, depending on the type of lesion. This study has implications for the practice of digital mammography.

Aged↗

Quantification of coronary artery calcium using multidetector CT and a retrospective ECG-gating reconstruction algorithm.

OBJECTIVE: The purpose of our study was to evaluate the quality of and motion artifacts on multidetector CT scans and to compare the results with those of and on electron beam CT scans for the assessment of coronary calcium scores. MATERIALS AND METHODS: First, 20 volunteers were scanned using multidetector CT. We compared the signal-to-noise ratio in the heart, motion artifacts at the heart border, and the highest CT values in the regions of the coronary arteries using single-sector and multisector reconstruction algorithms. Next, 60 patients with coronary calcified deposits underwent both multidetector CT and electron beam CT. We compared coronary calcium scores determined with multidetector CT using the two algorithms (thresholds of 90 and 130 H) with those determined using electron beam CT. RESULTS: The signal-to-noise ratio was higher and motion artifacts were reduced when we used the multisector algorithm. The highest CT value in the region of the coronary arteries exceeded 90 H in one of 55 arteries on the multisector algorithm images and 17 of 55 arteries on single-sector algorithm images (chi-square test, p < 0.01). In coronary calcium scoring, correlation coefficients ranged from 0.920 to 0.992 (Pearson's product moment) and from 0.932 to 0.969 (Spearman's rank correlation coefficient). CONCLUSION: Multidetector CT with a retrospective ECG-gating algorithm (multisector reconstruction) produced cardiac images with fewer motion artifacts and showed a high correlation with coronary calcium scores determined using electron beam CT. Therefore, multidetector CT is a potential tool for coronary calcium scoring.

Adult↗

Improving efficacy of diabetes management using treatment algorithms in a mainly Hispanic population.

OBJECTIVE: To compare clinical outcomes obtained using treatment algorithms versus standard "usual care" to treat patients with type 2 diabetes in a community setting. RESEARCH DESIGN AND METHODS: An observational group comparison was implemented in three community-based clinics in San Antonio, Texas: 1). a community clinic following treatment algorithms (CC-TA), 2). university clinic following treatment algorithms (UC-TA), and 3). a community clinic following standard "usual care" practices (CC-SC). Three hundred fifty-eight recently diagnosed type 2 diabetic patients (90% Mexican American, from low-income neighborhoods) who were consecutively identified at the three clinics were recruited. Following medical and laboratory evaluation, participants were started on treatment for hyperglycemia, hypertension, and dyslipidemia and followed for 12 months. RESULTS: Decrements in HbA(1c) at 12 months in the CC-TA and UC-TA were 3.1 and 3.3%, respectively, compared to 1.3% in the CC-SC (P < 0.0001). Corresponding decrements in fasting plasma glucose at 12 months were 94 and 99 mg/dl, respectively, versus 38 mg/dl in CC-SC (P < 0.0001). Reductions in total cholesterol, LDL cholesterol, and triglycerides at 12 months were greater in both algorithm-managed clinics compared to standard care-managed clinics (P < 0.0001). In algorithm-managed clinics, there were 30% more documented eye exams and 24% more documented foot exams than in standard care-managed patients. CONCLUSIONS: Adherence to the treatment algorithms improved metabolic outcomes in type 2 diabetic patients to a greater extent than standard care practices. These results have important clinical implications for the treatment of type 2 diabetic patients.

Adult↗

Evaluation of shading algorithms for surface display: depth information, surface orientation, colour and transparency.

When interpreting a shaded surface image the observer must infer a three-dimensional shape from a two-dimensional image. The principal monocular cues used in this process are surface orientation and apparent depth. Four shading algorithms were compared, ranging from pure depth to pure surface orientation with two intermediates. Eight observers assessed these algorithms using 40 sets of images showing test objects derived from emission computed axial tomograms, X-ray computed tomograms and simulated data. The results demonstrated a highly significant preference (p less than 0.01) for surface orientation over depth information for all observers and both imaging modalities. The coefficient of concordance showed that the observers were in good agreement as to the rank order of the algorithms, with significant agreement (p less than 0.05) for 37 of the 40 sets of images. The overall preferred algorithm was based on a local polynomial fitting procedure and contained primarily surface information. This shading algorithm was extended to include colour, which was used both as an arbitrary surface property to identify parts of a complex object and as a means of conveying temporal information. Further extension of the algorithm to the display of transparent surfaces was facilitated by an illumination model based on purely isotropic light. This enabled even irregular surfaces to be displayed as transparent objects, and was combined with opaque shading for displaying nested surfaces in nuclear magnetic resonance data.

Algorithms↗

Comparing adaptive and non-adaptive algorithms for cancer early detection with novel biomarkers.

It may be possible to reduce cancer mortality by monitoring the concentrations of serum biomarkers over time in men and women to detect their cancer early, when it is most curable. The simplest approach to using a biomarker for screening is to sequentially use fixed thresholds as a means to determine an abnormal test (e.g., PSA exceeding 4 mg/ml, CA 125 exceeding 30 U/ml). Alternatives to the simplest single threshold (ST) rules include more sophisticated algorithms that make use of screening history that accumulates over time and determines abnormal tests using individualized reference ranges. Although in principle longitudinal algorithms should out perform fixed threshold rules, the actual benefit gained will depend on behavior of the biomarker, the screening algorithm, and the screening frequency. Little information has been available to help predict when conditions should compel the adoption of the more sophisticated algorithms and when conditions suggest the simpler algorithms should suffice, or indeed be preferred. In this manuscript we evaluate the conditions under which one should expect great benefit, and when one should not expect benefit, by comparing the ability of simple and complex algorithms to detect cancer early under a variety of biomarker behaviors and screening frequencies.

Algorithms↗

Increase in corneal asphericity after standard laser in situ keratomileusis for myopia is not inherent to the Munnerlyn algorithm.

PURPOSE: Standard refractive surgery for myopia induces a shift in corneal asphericity toward positive values, resulting in an increase of spherical aberration. Analytical studies of changes in theoretical corneal shape after application of standard algorithms have yielded controversial conclusions. This study tries to resolve this controversy and discusses causes of optical degradation after refractive surgery. METHODS: Computationally, we subtracted from real preoperative corneas the ablation depth given by the Munnerlyn equation and the parabolic approximation of the Munnerlyn equation. We compared the predicted postoperative corneal asphericity (and corneal spherical aberration) with real postoperative corneal asphericities of the same eyes, after laser in situ keratomileusis (LASIK). RESULTS: Corneal asphericity increased after LASIK in real eyes, with an increase proportional to the amount of correction. This increase was not predicted by the computational application of the Munnerlyn algorithm, which predicted a slight decrease of corneal asphericity. The parabolic approximation of the Munnerlyn algorithm produced an increase in corneal asphericity that correlated with the amount of correction, but was less than the clinical findings. CONCLUSION: Potential causes for increased asphericity (radial changes in laser efficiency, epithelial healing, and biomechanical response) are discussed. These conclusions are important for the design of optimized and customized ablation algorithms, since the theoretical performance of a given ablation algorithm (ie, Munnerlyn algorithm) can differ drastically from real outcomes.

Adult↗

A computer algorithm for calculating the adequacy of antidepressant treatment in unipolar and bipolar depression.

BACKGROUND: Major depression is often treated with medications in doses that are too low or too short in duration. We published an early version of the Antidepressant Treatment History Form (ATHF) that rates the adequacy of antidepressant treatment. The updated ATHF presented here includes newer medications and a computer algorithm to automate the evaluation of the adequacy of pharmacotherapy or electroconvulsive therapy for depression. METHOD: The computer algorithm was written in MS-DOS Q-BASIC and in Visual Basic 5.0. Treatment data from 47 depressed (Structured Clinical Interview for DSM-III-R) patients were scored by the computer algorithm and assigned a number from 0 to 5 for the adequacy of antidepressant treatment. A psychiatrist blinded to the computer ratings manually rated the treatment using the ATHF. RESULTS: The computer algorithm, based on an updated version of the ATHF, estimates the adequacy of treatment of unipolar and bipolar depression. Computer algorithm results agreed with those generated by a clinician completing the form manually (kappa = 0.88 to 1.00). CONCLUSION: The computer algorithm can be used to analyze large databases and may help reduce the morbidity and mortality associated with major depression by improving the assessment of adequacy of pharmacologic treatments for research and quality assurance purposes. The availability of the updated ATHF on the Internet for downloading allows for modifications according to the user's purposes.

Algorithms↗

[A multicenter evaluation of seven commercial ML-EM algorithms for SPECT image reconstruction using simulation data].

The maximum likelihood expectation maximization (ML-EM) algorithm has become available as an alternative to filtered back projection in SPECT. The actual physical performance may be different depending on the manufacturer and model, because of differences in computational details. The purpose of this study was to investigate the characteristics of seven different types of ML-EM algorithms using simple simulation data. Seven ML-EM algorithm programs were used: Genie (GE), esoft (Siemens), HARP-III (Hitachi), GMS-5500UI (Toshiba), Pegasys (ADAC), ODYSSEY-FX (Marconi), and Windows-PC (original software). Projection data of a 2-pixel-wide line source in the center of the field of view were simulated without attenuation or scatter. Images were reconstructed with ML-EM by changing the number of iterations from 1 to 45 for each algorithm. Image quality was evaluated after a reconstruction using full width at half maximum (FWHM), full width at tenth maximum (FWTM), and the total counts of the reconstructed images. In the maximum number of iterations, the difference in the FWHM value was up to 1.5 pixels, and that of FWTM, no less than 2.0 pixels. The total counts of the reconstructed images in the initial few iterations were larger or smaller than the converged value depending on the initial values. Our results for the simplest simulation data suggest that each ML-EM algorithm itself provides a simulation image. We should keep in mind which algorithm is being used and its computational details, when physical and clinical usefulness are compared.

Algorithms↗

Evaluation of syndromic patient management algorithm for urethral discharge.

OBJECTIVE: To determine feasibility, validity, and cost effectiveness of the syndromic approach to male patients with urethral discharge in Bandung, Indonesia. METHODS: The WHO algorithm on urethral discharge with no microscopy available was evaluated. Patients presented with a complaint of urethral discharge and if discharge was confirmed the algorithm was applied. Treatment covered gonococcal and chlamydial infection (ciprofloxacin 500 mg single oral dose plus doxycycline 100 mg, twice daily orally for 7 days). The gold standard for validation was gonococcal culture and chlamydia antigen detection. RESULTS: 140 male patients with a complaint of urethral discharge were enrolled; 119 had confirmed discharge and entered the decision tree: 107 were followed and 104 (97%) were clinically cured. Of the three patients with persistent discharge, one had a purulent urethral discharge, diagnosed as gonococcal urethritis and he was probably reinfected; two patients had a serous discharge and microbiological tests were negative. Overall, 106 out of 107 patients (99%) were microbiologically cured. Sensitivity of the algorithm is 100% and its positive predictive value (PPV) is 75% or 97% if validated against gold standard microbiological tests or Gram stain, respectively. Cost per patient is rupiah (Rp)5.894 ($US2.56) for the algorithm compared with Rp43.024 ($18.70) for full microbiological diagnosis. The cost estimate for an algorithm of urethral discharge with microscopy available is Rp6.432 ($2.80) CONCLUSION: The "symptom and sign" algorithm is fully adapted to the prevailing situation in primary healthcare settings, is acceptable to healthcare workers and patients (who are effectively treated at their first visit), is highly cost effective, is 100% sensitive (no false negatives, which is not the case with microbiological diagnosis), and has a high PPV, between 75% and 97%. It is an excellent patient management tool and a sound basis for partner notification so that it should have a major impact on STD/HIV control and prevention in both men and women.

Administration, Oral↗

Do management algorithms improve chest pain triage?

OBJECTIVE: To audit the use of management algorithms for chest pain in an emergency department. DESIGN AND SETTING: Prospective study of all patients with chest pain presenting to the emergency department of an urban teaching hospital between 12 January and 4 May 1997. Staff were asked to complete a standardised admission form that incorporated the risk stratification algorithms for managing patients with suspected acute coronary syndrome. MAIN OUTCOME MEASURES: Compliance with the use of management algorithms; concordance with a cardiologist's review of the triage grouping and admission/discharge decision; and major cardiovascular events over four months. RESULTS: Emergency department staff documented the triage group in 223 of 503 cases (45%). Concordance with the group assigned by a cardiologist was 70% (kappa = 0.73; SE kappa = 0.04). When the management algorithm was applied correctly, 92% of triage decisions were correct (95% confidence interval [CI], 87%-96%). The triage decision was less often correct when risk stratification was not done (78% [73%-83%], P < 0.001), overestimated (77% [66%-88%], P < 0.01), or underestimated (50% [18%-82%], P < 0.001). The proportion of patients free of major cardiovascular events at four-month follow-up was 50% for those with myocardial infarction with ST-segment elevation, 47% for those with a high short-term risk of an adverse cardiac event, 82% for those with intermediate risk, and 99% for those with a low risk or non-coronary chest pain (P < 0.001). CONCLUSIONS: Use of management algorithms by emergency staff was poor. When used, triage decisions were more likely to be correct. Subsequent outcome confirms that the NHMRC risk stratification algorithms are useful for prognostic stratification of patients with suspected acute coronary syndrome.

Adult↗

Evaluation of the WHO/UNICEF algorithm for integrated management of childhood illness between the ages of one week to two months.

OBJECTIVE: To evaluate the utility of the WHO/UNICEF algoritham for integrated management of childhood illness (IMCI) between the ages of 1 week to 2 months. DESIGN: Prospective observational. SETTING: The Outpatient Department and Emergency Room of a medical college hospital. METHODS: 129 infants presenting to Outpatient Department (n=70) or Emergency Room (n=59) were assessed and classified as per 'IMCI' algorithm and treatment required was identified. A detailed evaluation with all relevant investigations was also done for these subjects. The final diagnoses made and therapies instituted on this basis served as 'gold standard'. The diagnostic and therapeutic agreement between 'gold standard and the 'IMCI' was computed. RESULTS: More than one illness was present in 97(75.2%) of subjects as per 'gold standard' (mean 2.1). Subjects having any referral criteria as per 'IMCI' algorithm had a greater (p=0.002) co-existence of illnesses (mean 2.3 vs. 1.8 illnesses per child, respectively. IMCI algorithm covered majority (81-84%) of the recorded diagnoses either partly (40-41%) or fully (40-44%). The referral criteria proved quite sensitive (86-87%) in predicting hospitalization but had a lower specificity (53-58%). a total agreement with IMCI was found in 60-66% cases. The mismatch (34-40%) was more commonly of overdiagnosis (21-23%) rather than underdiagnosis (15-21%). The sensitivity of the algorithm to identify serious bacterial infection was high (96.1-96.5%) while the specificity was relatively low (51. 8-59.7%). Upper respiratory infection (URI)emerged as an important cause resulting in unnecessary referrals (13 out of 21 cases). Of the 43 cases identified as diarrhea by the algorithm, 6 had breast fed stools, which do not require any therapy. The 'IMCI' algorithm had a provision for preventive services of immunization and breastfeeding counseling (18% possibility of availing missed opportunities in both). CONCLUSION: There is a sound scientific basis for adopting IMCI approach even in young infants as there is a need to improve the specificity of referral criteria. Two important conditions identified for possible refinement are URI and breast fed stools

Algorithms↗

Algorithm for assessment of the oxygen, acid-base and electrolyte status (ALBOA BEACH).

To achieve accurate interpretation of blood gas analysis data in intensive care units, the oxygen, acid-base and electrolyte-metabolite profile of arterial blood should be comprehensively and adequately monitored and assessed. A number of diagnostic software programmes have been developed to assist clinicians in this and to help improve instruction in this field. In the present study we describe an algorithm and a programme for assessment of the oxygen, acid-base and electrolyte status of the arterial blood. The algorithm, as well as the software programme, is named ALBOA BEACH, which is an acronym of the programme's full name--ALgorithm for Blood Oxygen, Acid-Base, Electrolyte And respective CHarts. The algorithm takes account of the latest achievements in blood-gas analysis; it can be used both in on-line and off-line modes and is useful in the laboratory and pathophysiological assessment of blood-gas disorders. The algorithm is based on a rigorous pathophysiological analysis and the interpretation achieved as a result is much more accurate than usual. Thus it provides a most reliable basis for taking the right clinical decision and making the proper prognosis of the possible critical conditions. The algorithm also provides additional bases for interpretations of data in the borderline zones, with due warnings in cases of absence of physiological coherence between the various parameters and modules. The programme is designed to be used with the modern multifunctional blood-gas analysers; it can be of assistance in making diagnoses, in the training and research activity in the intensive care units and specialised blood gas laboratories.

Acid-Base Equilibrium↗