Prologla kalb cerrahisi yoğun bakım uzman sistemi

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.ÖZET Operasyon ertesi yoğun bakımda hasta, birbirleriyle ilişkili alt sistemlerden oluşan bir karmaşık sistem olarak düşünülür. Yoğun bakım, tedavilerin en kritik safhasıdır ve bu dönemde uzman sistemlerin otomatik çıkarsama olanağı, çok önemli yardımlar sağlayabilir. Bu tez çalışmasında YBD (Yoğun Bakım Danışmanı) olarak isimlendirilen, çıkarımda geriye zincirleme metodunu esas alan kural tabanlı bir yeni uzman sistem sunulmuştur. YBD yoğun bakım ortamında: 1. Myokardial depresyon, 2. Kardiak tamponat, 3. High afterload, 4. Yetersi''; onarım, 5. Hipovolemi, 6. Cerrahi kanama, 7. Pıhtılaşma def ekti konularında tanı ve tedavide danışmanlık yapmaktadır. Sistem istendiğinde tanıya varmada izlediği çıkarım zincirini kullanıcıya bildirme özelliğiyle öğretim amacı taşımaktadır. Ayrıca YBD uzmanlara yukarda bahsedilen patolojik durumlarla ilgili klinik deneyimler sonucu yeni kurallar ekleme olanağı vermektedir. Kanımızca yoğun bakım ortamında YBD'mn kritik durumlarda kullanılması, tedavide riski büyük ölçüde azaltacaktır. 48SUMMARY During a post surgical intensive care, the patient is considered as a complex integrated system composed of interrelated subsystems. Post operative intensive care period is the most critical stage of treatment and automated reasoning mechanism of expert systems can provide crucial help in handling such situations. în this study a new rule-based expert system with backward- chanining reasoning method named ICC (Intensive Care Consultant) is presented. In intensive care, ICC provides consultative advices about: 1. Myocardial depression, 2. Cardiac tamponate, 3. High afterload, 4. Inadequate operation, 5. Hypovolemia, 0. Surgical hemorrhage, 7. Coagulation defect. ICC can give the information to physicians about its inference chain for education. In adition, ICC permits experts in the field of pathologic conditions explained above to add now decision rules that they find useful in their clinical practice. It can be said that the application of ICC to critical situations in intensive care can greatly reduce the risks in medical treatments. 4

Pentoxifylline reduces injury of the brain in transient ischaemia

Objective - The beneficial effect of pentoxifylline (PTX) on ischaemic-reperfusion injury was assessed in a rat model of transient global cerebral ischaemia. Design - Randomized, controlled, prospective study. Setting - University research laboratory. Subjects - Thirty-six male Wistar albino rats. Interventions - Ischaemia was induced with a four-vessel occlusion technique in 24 animals with the duration of 15 minutes. Group I animals (n = 12) received PTX treatment started 20 minutes before the occlusion of carotid arteries (60 mg/kg bolus followed by infusion at 0.1 mg/kg/min). A similar volume of saline solution was used in animals of the control group (group 2, n = 12). The animals in group 3 (sham group, n = 12) were anaesthetized and subjected to operative dissections without vascular occlusion. Measurements - Physiological parameters and somatosensory evoked potentials (SEP) were monitored in animals before ischaemia, during ischaemia and in the first 30 minutes of reperfusion. Their neurological outcome had been clinically evaluated and scored up to 4 days post ischaemia. The intergroup differences were compared. Then the animals were sacrificed and their brains were processed for histopathological examination. Main results - In group 3, SEP amplitudes did not change during the procedures, and all animals recovered without neurologic deficits. At the end of the ischaemic period, the average amplitude was reduced to 4 ± 3% of the baseline in all ischaemic animals. This was followed by a gradual return to 92 ± 9% and 82 ± 8% of the initial amplitude after 30 minutes of reperfusion in group 1 and group 2, respectively (p < 0.05). The average neurological score was significantly higher in group 1 than in group 2 in the post-ischaemia period (p < 0.05). Histological observations were clearly correlated with the neurological findings. Conclusion - The results suggest that PTX reduces cerebral injury and preserves neurologic function in transient global ischaemia in rats

Pentoxifylline reduces injury of the brain in transient ischaemia

PubMed ID: 9684030Objective - The beneficial effect of pentoxifylline (PTX) on ischaemic-reperfusion injury was assessed in a rat model of transient global cerebral ischaemia. Design - Randomized, controlled, prospective study. Setting - University research laboratory. Subjects - Thirty-six male Wistar albino rats. Interventions - Ischaemia was induced with a four-vessel occlusion technique in 24 animals with the duration of 15 minutes. Group I animals (n = 12) received PTX treatment started 20 minutes before the occlusion of carotid arteries (60 mg/kg bolus followed by infusion at 0.1 mg/kg/min). A similar volume of saline solution was used in animals of the control group (group 2, n = 12). The animals in group 3 (sham group, n = 12) were anaesthetized and subjected to operative dissections without vascular occlusion. Measurements - Physiological parameters and somatosensory evoked potentials (SEP) were monitored in animals before ischaemia, during ischaemia and in the first 30 minutes of reperfusion. Their neurological outcome had been clinically evaluated and scored up to 4 days post ischaemia. The intergroup differences were compared. Then the animals were sacrificed and their brains were processed for histopathological examination. Main results - In group 3, SEP amplitudes did not change during the procedures, and all animals recovered without neurologic deficits. At the end of the ischaemic period, the average amplitude was reduced to 4 ± 3% of the baseline in all ischaemic animals. This was followed by a gradual return to 92 ± 9% and 82 ± 8% of the initial amplitude after 30 minutes of reperfusion in group 1 and group 2, respectively (p < 0.05). The average neurological score was significantly higher in group 1 than in group 2 in the post-ischaemia period (p < 0.05). Histological observations were clearly correlated with the neurological findings. Conclusion - The results suggest that PTX reduces cerebral injury and preserves neurologic function in transient global ischaemia in rats