Search

Search

这页已由机器翻译。其他页面可能仍然显示为英文。 View in English

首页
...
研究领域生物医学和临床科学瘤学和致癌症预测和预后标志物
在败血症中最佳的血管压缩启动:OVISS强化学习研究

在败血症中最佳的血管压缩启动:OVISS强化学习研究

Alexandre Kalimouttou ^1,2,3, Jason N Kennedy ^4,5, Jean Feng ⁶, Harvineet Singh ⁶, Suchi Saria ^7,8,9,10,11, Derek C Angus ^4,5, Christopher W Seymour ^4,5, Romain Pirracchio ^1,2,6

Alexandre Kalimouttou ^1,2,3, Jason N Kennedy ^4,5, Jean Feng ⁶

¹Inserm UMR 1153, Centre for Research in Epidemiology and Statistics (CRESS), ECSTRRA Team, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France.
²Department of Anesthesia & Perioperative Care, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco.
³Department of Anesthesiology and Intensive Care Medicine, Grenoble Alpes University Hospital, Grenoble, France.
⁴Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
⁵Center for Research, Investigation, and Systems Modeling of Acute Illness, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
⁶Department of Epidemiology & Biostatistics, University of California, San Francisco.
⁷Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, Maryland.
⁸Department of Computer Science, Johns Hopkins University, Baltimore, Maryland.
⁹Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
¹⁰Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
¹¹Bayesian Health, New York, New York.

⁰Inserm UMR 1153, Centre for Research in Epidemiology and Statistics (CRESS), ECSTRRA Team, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France.

Jama +

|

2025年三月18日

相关实验视频

These videos have been matched automatically. Contact us if they are not relevant.

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema

Published on: September 1, 2016

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Published on: April 18, 2025

See all related videos

在PubMed上查看摘要

概括

此摘要是机器生成的。

一个新的强化学习模型表明,在接受上腺素治疗的败血症患者中,应更早,更频繁地使用上腺素. 与标准护理相比,这种方法与较低的医院死亡率有关.

科学领域

危急护理医学
药理学
医疗保健中的人工智能

背景情况

上腺素是感染性休克的主要血管压缩剂.
最佳的时间和使用辅助血管压缩剂,如血管压缩剂仍然不清楚.

研究的目的

开发和验证强化学习 (RL) 模型,以在成年败血症患者中进行最佳的压缩剂启动.
通过定义数据驱动的血管压素施用策略来改善患者的治疗结果.

主要方法

基于电子健康记录数据的强化学习模型 (3608名患者).
在大型多中心数据集 (10,217名患者) 上使用加权重要性抽样验证模型.
与临床医生的实践相比,RL指导的血管压素启动.

主要成果

在较低的上腺素剂量下,RL模型推更早 (4小时 vs 5小时) 和更频繁 (87% vs 31%) 的输血压.
与临床医生的行动相比,以RL为指导的策略显示出更大的预期回报.
随着RL引导的血管压缩剂的启动,医院内死亡率显著降低 (OR,0. 81).

结论

一个强化学习模型提供了在败血症中血管压素启动的最佳规则.
这种模式比目前的做法更自由,更早地使用血管压缩剂.
这种以数据为导向的方法与重症患者的存活率有所改善.

相关实验视频

这些视频已自动匹配 Contact us 如果它们不相关

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema

Published on: September 1, 2016

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Published on: April 18, 2025

See all related videos

相关概念视频

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...

Share

X
Facebook
LinkedIn
YouTube

ABOUT JoVE

Overview
Leadership
Blog
JoVE Help Center

AUTHORS

Publishing Process
Editorial Board
Scope & Policies
Peer Review
FAQ
Submit

LIBRARIANS

Testimonials
Subscriptions
Access
Resources
Library Advisory Board
FAQ

RESEARCH

JoVE Journal
Methods Collections
JoVE Encyclopedia of Experiments
Archive

EDUCATION

JoVE Core
JoVE Business
JoVE Science Education
JoVE Lab Manual
Faculty Resource Center
Faculty Site

Terms & Conditions of Use
Privacy Policy
Policies