一个基于数据的模型,用于早期预测儿童重症监护病房患者需要侵入性机械通风的需要
Sanjukta N Bose1, Andrew Defante2, Joseph L Greenstein3
1Enterprise Data and Analytics, University of Maryland Medical System, Linthicum Heights, MD, United States of America.
PloS one
|August 4, 2023
概括
这项研究开发了一种预测模型,以早期识别需要机械通风 (MV) 的儿科重症监护室 (PICU) 患者. 该模型使用临床和药物数据,提供了一个关键的早期预警期,以潜在地避免MV.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 医疗信息学 医疗信息学
- 医疗保健中的机器学习
背景情况:
- 急性呼吸衰竭是儿科重症监护病房 (PICU) 中的一个关键状态.
- 在严重的病例中,机械通风 (MV) 往往是生存的必要条件.
- 早期识别患有MV风险的患者可以改善临床结果.
研究的目的:
- 开发一个基于数据的模型,用于在PICU患者中早期预测MV的必要性.
- 建立一个早期预警期,以便临床医生在需要MV之前进行干预.
主要方法:
- 一项对13,651名PICU患者进行的回顾性观察研究.
- 使用XGBoost和具有药物历史的卷积神经网络 (CNN) 的预测模型的开发.
- 从ROC曲线计算一个时间变化的风险得分和一个最佳值,以确定早期预测点 (EPP) 和早期预警时间 (EWT).
- 频谱聚类用于根据风险得分轨迹识别患者组.
主要成果:
- 基于临床和药物史的模型实现了0.89.89的AUROC.
- 该模型表现出高特异性 (0.95) 和NPV (0.95),平均EWT为9.9小时.
- 集群确定了EPP后的三组患者,其中最高风险组的PPV为0.92.
结论:
- 这项研究提出了一种利用药物历史的新方法,用于预测儿科患者的MV需求.
- 开发的模型提供了有价值的早期预警期,可能使及时干预成为可能.
- 这些发现强调了机器学习在主动重症监护管理中的实用性.
相关概念视频
Mechanical Ventilation II: Invasive Ventilation
178
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
178
Mechanical Ventilation I: Indication and Settings
478
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
478
Mechanical Ventilation III: Noninvasive Ventilation
151
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
151
Assessment of Ventilation I: Respiratory Rate
1.2K
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.2K
Ventilatory Modes
216
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
216


