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https://www.readbyqxmd.com/read/28227974/heart-rate-variability-as-a-biomarker-for-sedation-depth-estimation-in-icu-patients
#1
Sunil B Nagaraj, Sowmya M Ramaswamy, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M Mcclain, Eric S Rosenthal, Patrick L Purdon, M Brandon Westover, Sunil B Nagaraj, Sowmya M Ramaswamy, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M Mcclain, Eric S Rosenthal, Patrick L Purdon, M Brandon Westover, M Brandon Westover, Sunil B Nagaraj, Siddharth Biswal, Sowmya M Ramaswamy, Lauren M Mcclain, David W Zhou, Emily J Boyle, Patrick L Purdon, Eric S Rosenthal
An automated patient-specific system to classify the level of sedation in ICU patients using heart rate variability signal is presented in this paper. ECG from 70 mechanically ventilated adult patients with administered sedatives in an ICU setting were used to develop a support vector machine based system for sedation depth monitoring using several heart rate variability measures. A leave-one-subject-out cross validation was used for classifier training and performance evaluations. The proposed patient-specific system provided a sensitivity, specificity and an AUC of 64%, 84...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227782/predicting-short-term-icu-outcomes-using-a-sequential-contrast-motif-based-classification-framework
#2
Shameek Ghosh, Hung Nguyen, Jinyan Li, Shameek Ghosh, Hung Nguyen, Jinyan Li, Shameek Ghosh, Hung Nguyen, Jinyan Li
Critical ICU events like acute hypotension and septic shock are dangerous complications, leading to multiple organ failures and eventual death. Previously, pattern mining algorithms have been employed for extracting interesting rules in various clinical domains. However, the extracted rules are directly investigated by clinicians for diagnosing a disease. Towards this purpose, there is a need to develop advanced prediction models which integrate dynamic patterns to learn a patient's physiological condition...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227709/bayesian-gaussian-processes-for-identifying-the-deteriorating-patient
#3
Glen Wright Colopy, Marco A F Pimentel, Stephen J Roberts, David A Clifton, Glen Wright Colopy, Marco A F Pimentel, Stephen J Roberts, David A Clifton, Glen Wright Colopy, Marco A F Pimentel, Stephen J Roberts, David A Clifton
The step-down unit (SDU) is a high-acuity hospital environment, to which patients may be sent after discharge from the intensive care unit (ICU). About 1- in-7 patients will deteriorate in the SDU and require emergency readmission to the ICU. Upon readmission, these patients experience significantly higher mortality risks and lengths of stay. Gaussian process regression (GPR) models are proposed as a flexible, principled, probabilistic method to address the clinical need to monitor continuously patient time-series of vital signs acquired in the SDU...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227227/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#4
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227034/a-novel-algorithm-for-reducing-false-arrhythmia-alarms-in-intensive-care-units
#5
Chandan Srivastava, Sonal Sharma, Ali Jalali, Chandan Srivastava, Sonal Sharma, Ali Jalali, Ali Jalali, Chandan Srivastava, Sonal Sharma
Alarm fatigue in intensive care units (ICU) is one of the top healthcare issues in the US. False alarms in ICU will decrease the quality of care and staff response time over the alarms. Normally, false alarm will cause desensitization of the clinical staff which leads to warnings and misleading, if the triggered alarm is true. In this study, we have proposed a multi-model ensemble approach to reduce the false alarm rate in monitoring systems. We have used 750 patient records from PhysioNet database. At First arrhythmia based features from electrocardiogram (ECG), arterial blood pressure (ABP) and photoplethysmogram (PPG) features were extracted from the records...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227033/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#6
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Mohamed Rehman, Ali Jalali, Vinay Nadkanri, Dieter Bender, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227019/prediction-using-patient-comparison-vs-modeling-a-case-study-for-mortality-prediction
#7
Mark Hoogendoorn, Ali El Hassouni, Kwongyen Mok, Marzyeh Ghassemi, Peter Szolovits, Mark Hoogendoorn, Ali El Hassouni, Kwongyen Mok, Marzyeh Ghassemi, Peter Szolovits, Kwongyen Mok, Ali El Hassouni, Peter Szolovits, Marzyeh Ghassemi, Mark Hoogendoorn
Information in Electronic Medical Records (EMRs) can be used to generate accurate predictions for the occurrence of a variety of health states, which can contribute to more pro-active interventions. The very nature of EMRs does make the application of off-the-shelf machine learning techniques difficult. In this paper, we study two approaches to making predictions that have hardly been compared in the past: (1) extracting high-level (temporal) features from EMRs and building a predictive model, and (2) defining a patient similarity metric and predicting based on the outcome observed for similar patients...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226652/early-warnings-of-heart-rate-deterioration
#8
Vania G Almeida, Ian T Nabney, Vania G Almeida, Ian T Nabney, Ian T Nabney, Vania G Almeida
Hospitals can experience difficulty in detecting and responding to early signs of patient deterioration leading to late intensive care referrals, excess mortality and morbidity, and increased hospital costs. Our study aims to explore potential indicators of physiological deterioration by the analysis of vital-signs. The dataset used comprises heart rate (HR) measurements from MIMIC II waveform database, taken from six patients admitted to the Intensive Care Unit (ICU) and diagnosed with severe sepsis. Different indicators were considered: 1) generic early warning indicators used in ecosystems analysis (autocorrelation at-1-lag (ACF1), standard deviation (SD), skewness, kurtosis and heteroskedasticity) and 2) entropy analysis (kernel entropy and multi scale entropy)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226613/using-demographic-and-time-series-physiological-features-to-classify-sepsis-in-the-intensive-care-unit
#9
Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Kristin Gunnarsdottir, Vijay Sadashivaiah, Matthew Kerr, Sabato Santaniello, Sridevi V Sarma, Sridevi V Sarma, Sabato Santaniello, Kristin Gunnarsdottir, Matthew Kerr, Vijay Sadashivaiah
Sepsis, a systemic inflammatory response to infection, is a major health care problem that affects millions of patients every year in the intensive care units (ICUs) worldwide. Despite the fact that ICU patients are heavily instrumented with physiological sensors, early sepsis detection remains challenging, perhaps because clinicians identify sepsis by (i) using static scores derived from bed-side measurements individually, and (ii) deriving these scores at a much slower rate than the rate for which patient data is collected...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226045/nursing-practice-environment-and-work-satisfaction-in-critical-units
#10
Elaine Machado de Oliveira, Ricardo Luis Barbosa, Rafaela Andolhe, Flavia Regina Cocuzza das Eiras, Katia Grillo Padilha
Objective: to analyze the association between the environment of nursing practices and work satisfaction in Intensive Care Units (ICU). Method: a cross-sectional study was performed in eight adult ICUs of a public university hospital between 2012 and 2015. The Nursing Work Index-Revised (NWI-R), in their short forms, and the Index of Work Satisfaction (IWS) were applied to investigate the environment of nursing practices and work satisfaction, respectively. Results: a total of 100 (34...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28226040/assessing-the-adequacy-of-workload-measurement-tools-using-a-quality-based-methodology
#11
Maria Fuensanta Hellín Gil, Maria José López Montesinos, Ana Myriam Seva Llor, Maria Pilar Ferrer Bas, Maria Loreto Maciá Soler
Objective: determine which tool (NEMS and NAS) is most suitable for use in intensive care units using a quality-based methodology. Method: after identifying the opportunity for improvement "Inadequacy of the NEMS for determining nursing workload in the intensive care unit (ICU)", we assessed the NEMS and the NAS, as a proposed improvement to the NEMS, using quality improvement cycles methodology based on the following criteria: measurement of daily nursing workload on a daily and shift basis; the tool encompasses all nursing activities undertaken in the ICU; and workload assessed per patient and unit...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28226029/predictive-value-of-c-reactive-protein-in-critically-ill-patients-after-abdominal-surgery
#12
Frédéric Sapin, Patrick Biston, Michael Piagnerelli
OBJECTIVES: The development of sepsis after abdominal surgery is associated with high morbidity and mortality. Due to inflammation, it may be difficult to diagnose infection when it occurs, but measurement of C-reactive protein could facilitate this diagnosis. In the present study, we evaluated the predictive value and time course of C-reactive protein in relation to outcome in patients admitted to the intensive care unit (ICU) after abdominal surgery. METHODS: We included patients admitted to the ICU after abdominal surgery over a period of two years...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#13
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225315/improving-glycemic-control-safely-in-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#14
Gregory A Maynard, Janet Holdych, Heather Kendall, Karen Harrison, Patricia A Montgomery, Kristen Kulasa
Objective Safely improve glycemic control in the critical care units of nine hospitals. Methods Critical care adult inpatients from nine hospitals with ≥ 4 point-of-care (POC) blood glucose (BG) readings over ≥ 2 days were targeted by collaborative improvement efforts to reduce hyper- and hypo-glycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline, or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data. Collaborative interventions included standardized insulin infusion protocols, hypoglycemia prevention bundles, audit and feedback, education, and measure-vention (coupling measurement of patients "off protocol" with concurrent interventions to correct suboptimal care)...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28224729/management-of-hypoxaemic-respiratory-failure-in-a-respiratory-high-dependency-unit
#15
Craig Hukins, Mimi Wong, Michelle Murphy, John Upham
BACKGROUND: There are limited data on outcomes of hypoxaemic respiratory failure (HRF), especially in non-ICU settings. AIM: To assess outcomes in HRF (without multi-system disease and not requiring early intubation) directly admitted to a Respiratory High Dependency Unit (R-HDU). METHODS: Retrospective, cohort study of HRF compared to Hypercapnic Respiratory Failure (HCRF) in a R-HDU (2007-2011). Patient characteristics (age, gender, pre-morbid status, diagnoses) and outcomes (non-invasive ventilation (NIV) use, survival, ICU admission) were assessed...
February 22, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28224645/clinical-decision-support-systems-differ-in-their-ability-to-identify-clinically-relevant-drug-interactions-of-immunosuppressants-in-kidney-transplant-patients
#16
J Amkreutz, A Koch, L Buendgens, C Trautwein, A Eisert
WHAT IS KNOWN AND OBJECTIVE: In kidney transplant patients, clinically relevant drug-drug interactions (DDIs) with immunosuppressants potentially lead to serious adverse drug events (ADEs). The aim of this study was (i) to show that five clinical decision support systems (CDSSs) differ in their ability to identify clinically relevant potential DDIs (pDDIs) of immunosuppressants in kidney transplant patients and (ii) to compare CDSSs in terms of their ability to identify clinically relevant pDDIs in this context...
February 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28224564/increased-glucocorticoid-receptor-expression-in-sepsis-is-related-to-heat-shock-proteins-cytokines-and-cortisol-and-is-associated-with-increased-mortality
#17
Konstantinos Vardas, Stavroula Ilia, Amalia Sertedaki, Evangelia Charmandari, Efrossini Briassouli, Dimitris Goukos, Kleovoulos Apostolou, Katerina Psarra, Efthimia Botoula, Stylianos Tsagarakis, Eleni Magira, Christina Routsi, Constantine A Stratakis, Serafim Nanas, George Briassoulis
BACKGROUND: The purposes of this study are to examine if the human glucocorticoid receptor (hGR) isoform-α mRNA and hGR protein expressions are deficient in the acute phase of sepsis (S) compared to systemic inflammatory response syndrome (SIRS) and healthy subjects (H) and to evaluate if the hGRα and hGR alterations are associated with cortisol changes and if they are related to (1) extracellular and intracellular heat shock proteins (HSP) 72 and 90α; (2) ACTH, prolactin, and interleukins (ILs); and (3) outcome...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28224111/attributable-cost-of-a-nosocomial-infection-in-the-intensive-care-unit-a-prospective-cohort-study
#18
Binila Chacko, Kurien Thomas, Thambu David, Hema Paul, Lakshmanan Jeyaseelan, John Victor Peter
AIM: To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS: Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224108/implementation-of-enteral-feeding-protocol-in-an-intensive-care-unit-before-and-after-study
#19
Martin Padar, Gerli Uusvel, Liis Starkopf, Joel Starkopf, Annika Reintam Blaser
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection Control Service...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224104/exertional-rhabdomyolysis-and-heat-stroke-beware-of-volatile-anesthetic-sedation
#20
REVIEW
Karel Heytens, Jan De Bleecker, Walter Verbrugghe, Jonathan Baets, Luc Heytens
In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units (ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique...
February 4, 2017: World Journal of Critical Care Medicine
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