告知密集护理单位数字双胞胎:动态评估心脏呼吸衰竭的轨迹在患者与化症
Grace Yao Hou1, Amos Lal2, Phillip J Schulte3
1Department of Industrial and Systems Engineering, University of Florida, Gainesville, Florida.
在使用机器学习的败血症患者中,确定了四种不同的临床轨迹. 这些患者途径,包括快速康复和快速衰退,有助于预测结果并改善重症监护资源规划.
科学领域:
- 关键护理医学 关键护理医学
- 医疗信息学 医疗信息学
- 医疗保健中的机器学习
背景情况:
- 了解败血症患者的临床轨迹对于预后和资源分配至关重要.
- 对心肺呼吸系统支持的动态评估是建模患者进展的关键.
- 现有的模型可能无法完全捕捉重症监护室 (ICU) 中的各种临床途径.
研究的目的:
- 确定进入ICU的败血症患者的常见临床轨迹.
- 利用电子健康记录数据进行动态轨迹建模.
- 为关键疾病管理的数字双胞胎模型的开发提供信息.
主要方法:
- 在8年内,对19177名进入梅奥诊所医院重症监护室的败血症患者进行了回顾性队列研究.
- 无监督的机器学习 (两阶段集群) 应用到模型患者的轨迹,直到ICU入院后的14天.
- 基于心肺呼吸系统支持动态和医院出院状态的建模.
主要成果:
- 确定了四种不同的临床轨迹:快速恢复 (27%),缓慢恢复 (62%),快速衰退 (4%) 和延迟衰退 (7%).
- 死亡率差异很大:快速恢复的3.5%,缓慢恢复的3.6%,快速衰退的99.7%,延迟衰退的97.9%.
- 轨迹通过查尔森并发症指数,APACHE III分数和SOFA分数 (P < 0.001) 进行了强有力的区分.
结论:
- 败血症患者的临床轨迹可以有效地使用机器学习对EHR数据进行建模.
- 确定的轨迹为预测模型和数字双胞胎决策支持工具提供了基础.
- 这些见解可以改善共享决策并优化重症监护中的资源规划.
更多相关视频
14:28Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care
Published on: May 10, 2024
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
相关概念视频
Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
Acute Respiratory Failure-III
Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Acute Respiratory Failure-IV
