A Digital Clinical Guideline Based on HL7 Arden Syntax for the Treatment of Children with Traumatic Brain Injury.

BACKGROUND: Intracranial hypertension is a serious complication accompanying the intensive care of children with traumatic brain injury. Intensive care of these patients is based on internationally accepted guidelines and their local editions. OBJECTIVE: The goal was to develop a software system for digital implementation of the clinical protocol for the treatment of intracranial hypertension in children, based on HL7 Arden Syntax clinical decision support. METHODS: Arden Syntax, an HL7 medical knowledge representation and processing standard, was used to develop a digital version of the local guideline. RESULTS: Comparison of 37 patients given conventional treatment with a second group of 84 patients treated with the digital clinical guideline yielded statistically significant differences. CONCLUSION: The digital clinical guideline system undoubtedly improves the doctor's awareness of the patient's existing condition and potential complications of intracranial hypertension.

Cerebral Autoregulation Monitoring and Online Arden Syntax Clinical Decision Support for the Treatment of Intracranial Hypertension in Children with Traumatic Brain Injury.

BACKGROUND: 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.

Integral Homeostasis Index in a Decision Support System for the Assessment and Prediction of the Clinical Condition of Children with Severe Mechanical Trauma.

OBJECTIVE: Daily assessment of the acid-base balance (ABB) in blood is one of the important elements of multi-parameter patient monitoring at intensive care units (ICUs). The present work aims to determine the effectiveness and validity of the integral homeostasis index IHx calculated from ABB blood test data for the assessment and prognosis of children with critical traumatic conditions. METHODS: 345 patients were studied. IHx was calculated and the data were subjected to statistical evaluation. An Arden-Syntax-based clinical decision support (CDS) platform was used. One purpose of the study was to incorporate the platform into the ICU IT landscape of the hospital, and the second purpose was to develop a CDS module for the calculation of IHx and present the results in real time to the attending physician. RESULTS: Integral homeostasis index IHx calculations as well as their prompt assessment permit better and more rapid treatment of children with severe traumatic injury.