keyword
https://read.qxmd.com/read/38536802/predicting-successful-weaning-from-mechanical-ventilation-by-reduction-in-positive-end-expiratory-pressure-level-using-machine-learning
#1
JOURNAL ARTICLE
Seyedmostafa Sheikhalishahi, Mathias Kaspar, Sarra Zaghdoudi, Julia Sander, Philipp Simon, Benjamin P Geisler, Dorothea Lange, Ludwig Christian Hinske
Weaning patients from mechanical ventilation (MV) is a critical and resource intensive process in the Intensive Care Unit (ICU) that impacts patient outcomes and healthcare expenses. Weaning methods vary widely among providers. Prolonged MV is associated with adverse events and higher healthcare expenses. Predicting weaning readiness is a non-trivial process in which the positive end-expiratory pressure (PEEP), a crucial component of MV, has potential to be indicative but has not yet been used as the target...
March 2024: PLOS Digit Health
https://read.qxmd.com/read/38536558/a-deep-learning-model-for-translating-ct-to-ventilation-imaging-analysis-of-accuracy-and-impact-on-functional-avoidance-radiotherapy-planning
#2
JOURNAL ARTICLE
Zhen Hou, Youyong Kong, Junxian Wu, Jiabing Gu, Juan Liu, Shanbao Gao, Yicai Yin, Ling Zhang, Yongchao Han, Jian Zhu, Shuangshuang Li
PURPOSE: Radiotherapy planning incorporating functional lung images has the potential to reduce pulmonary toxicity. Free-breathing 4DCT-derived ventilation image (CTVI) may help quantify lung function. This study introduces a novel deep-learning model directly translating planning CT images into CTVI. We investigated the accuracy of generated images and the impact on functional avoidance planning. MATERIALS AND METHODS: Paired planning CT and 4DCT scans from 48 patients with NSCLC were randomized to training (n = 41) and testing (n = 7) data sets...
March 27, 2024: Japanese Journal of Radiology
https://read.qxmd.com/read/38535673/a-3d-printed-portable-uv-and-visible-photoreactor-for-water-purification-and-disinfection-experiments
#3
JOURNAL ARTICLE
Nelson Castro, Joana M Queirós, Dinis C Alves, Margarida M Macedo Fernandes, Senetxu Lanceros-Méndez, Pedro M Martins
Water scarcity and contamination are urgent issues to be addressed. In this context, different materials, techniques, and devices are being developed to mitigate contemporary and forthcoming water constraints. Photocatalysis-based approaches are suitable strategies to address water contamination by degrading contaminants and eliminating microbes. Photoreactors are usually designed to perform photocatalysis in a scalable and standardised way. Few or none have been developed to combine these characteristics with portability, flexibility, and cost effectiveness...
March 15, 2024: Nanomaterials
https://read.qxmd.com/read/38535104/transferring-surgical-expertise-analyzing-the-learning-curve-of-robotic-cardiac-surgery-operative-time-reduction-when-surgeon-moves-from-one-experienced-center-to-another
#4
JOURNAL ARTICLE
Sherif M Khairallah, Mohamed Rahouma, Stephanie L Mick
BACKGROUND: Robotically assisted cardiac surgery is performed in a team setting and is well known to be associated with learning curves. Surgeon and operative team learning curves are distinct entities, with total operative time representing the entire operative team (surgery, anesthesia, nursing, and perfusion) and cross-clamp time representing mainly the surgical team. Little is known about how a team learning curve evolves when an experienced surgeon transitions from one surgical center to another...
February 29, 2024: Journal of Cardiovascular Development and Disease
https://read.qxmd.com/read/38532926/combined-frequency-domain-near-infrared-spectroscopy-and-diffuse-correlation-spectroscopy-system-for-comprehensive-metabolic-monitoring-of-inspiratory-muscles-during-loading
#5
JOURNAL ARTICLE
Carlos A Gómez, Laurent Brochard, Ewan C Goligher, Dmitry Rozenberg, W Darlene Reid, Darren Roblyer
SIGNIFICANCE: Mechanical ventilation (MV) is a cornerstone technology in the intensive care unit as it assists with the delivery of oxygen in critically ill patients. The process of weaning patients from MV can be long and arduous and can lead to serious complications for many patients. Despite the known importance of inspiratory muscle function in the success of weaning, current clinical standards do not include direct monitoring of these muscles. AIM: The goal of this project was to develop and validate a combined frequency domain near-infrared spectroscopy (FD-NIRS) and diffuse correlation spectroscopy (DCS) system for the noninvasive characterization of inspiratory muscle response to a load...
March 2024: Journal of Biomedical Optics
https://read.qxmd.com/read/38531748/development-of-a-machine-learning-model-for-prediction-of-the-duration-of-unassisted-spontaneous-breathing-in-patients-during-prolonged-weaning-from-mechanical-ventilation
#6
JOURNAL ARTICLE
Sebastian Johannes Fritsch, Morris Riedel, Gernot Marx, Johannes Bickenbach, Andreas Schuppert
PURPOSE: Treatment of patients undergoing prolonged weaning from mechanical ventilation includes repeated spontaneous breathing trials (SBTs) without respiratory support, whose duration must be balanced critically to prevent over- and underload of respiratory musculature. This study aimed to develop a machine learning model to predict the duration of unassisted spontaneous breathing. MATERIALS AND METHODS: Structured clinical data of patients from a specialized weaning unit were used to develop (1) a classifier model to qualitatively predict an increase of duration, (2) a regressor model to quantitatively predict the precise duration of SBTs on the next day, and (3) the duration difference between the current and following day...
March 26, 2024: Journal of Critical Care
https://read.qxmd.com/read/38531327/delivery-room-resuscitation-of-infants-with-congenital-diaphragmatic-hernia-lessons-learned-through-video-review
#7
JOURNAL ARTICLE
K Taylor Wild, Natalie Rintoul, Holly L Hedrick, Lauren Heimall, Leane Soorikian, Elizabeth E Foglia, Anne M Ades, Heidi M Herrick
INTRODUCTION: Delivery room (DR) interventions for infants with congenital diaphragmatic hernia (CDH) are not well described. This study sought to describe timing and order of DR interventions and identify system factors impacting CDH DR resuscitations using a human factors framework. METHODS: Single center observational study of video recorded CDH DR resuscitations documenting timing and order of interventions. The team used the Systems Engineering Initiative for Patient Safety (SEIPS) model to identify system factors impacting DR resuscitations and time to invasive ventilation...
March 26, 2024: Fetal Diagnosis and Therapy
https://read.qxmd.com/read/38530502/the-evaluation-of-a-non-invasive-respiratory-monitor-in-ards-patients-in-supine-and-prone-position
#8
JOURNAL ARTICLE
Tommaso Pozzi, Silvia Coppola, Elena Chiodaroli, Federico Cucinotta, Francesca Becci, Davide Chiumello
PURPOSE: The Prone positioning in addition to non invasive respiratory support is commonly used in patients with acute respiratory failure. The aim of this study was to assess the accuracy of an impedance-based non-invasive respiratory volume monitor (RVM) in supine and in prone position. METHODS: In sedated, paralyzed and mechanically ventilated patients in volume-controlled mode with acute respiratory distress syndrome scheduled for prone positioning it was measured and compared non-invasively tidal volume and respiratory rate provided by the RVM in supine and, subsequently, in prone position, by maintaining unchanged the ventilatory setting...
March 26, 2024: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/38530215/fragmentation-of-the-qrs-complex-is-associated-with-right-ventricular-dilatation-and-mortality-in-critically-unwell-coronavirus-disease-2019-patients
#9
JOURNAL ARTICLE
Randeep S Heer, Faye L Selby, Amit J K Mandal, Vadir Baktash, Piotr Szawarski, Sirtaaj Mattoo, Hasan Mohiaddin, Kanchani K Makuloluwa, Hussein Chreif, Fouad R Amin, Constantinos G Missouris
BACKGROUND: QRS fragmentation (fQRS) is a depolarization disorder that can be detected on routine electrocardiography (ECG). Current evidence suggests that fQRS is a prognosticator of adverse cardiovascular events. This study aimed to assess the relationship between fQRS and all-cause mortality in critically unwell coronavirus disease 2019 (COVID-19) patients and to investigate the significance of associated abnormalities on echocardiography. METHODS: A retrospective cohort study of COVID-19 patients in a critical care setting was performed...
March 26, 2024: Anatolian Journal of Cardiology
https://read.qxmd.com/read/38529620/spinal-muscular-atrophy-sma-mortality-despite-novel-medications-case-reports
#10
JOURNAL ARTICLE
John R Bach, Nayara Conceição, Miguel R Goncalves
Despite new effective medications, patients with SMA types 1-3 can continue to have inadequate cough flows to prevent episodes of acute respiratory failure. Ventilator unweanable intubated patients are thought to require tracheostomy tubes. As a result, potentially beneficial medications may be discontinued and patients die despite receiving these medications. Three cases are presented of medically treated, physically strengthening children, with SMA type 1. All three subsequently died or underwent tracheotomy...
March 25, 2024: American Journal of Physical Medicine & Rehabilitation
https://read.qxmd.com/read/38529120/development-and-validation-of-a-prediction-score-for-failure-to-casirivimab-imdevimab-in-hospitalized-patients-with-covid-19-pneumonia
#11
JOURNAL ARTICLE
Alessandro Cozzi-Lepri, Vanni Borghi, Salvatore Rotundo, Bianca Mariani, Anna Ferrari, Cosmo Del Borgo, Francesca Bai, Pietro Colletti, Piermauro Miraglia, Carlo Torti, Anna Maria Cattelan, Giovanni Cenderello, Marco Berruti, Carlo Tascini, Giustino Parruti, Simona Coladonato, Andrea Gori, Giulia Marchetti, Miriam Lichtner, Luigi Coppola, Chiara Sorace, Alessandra D'Abramo, Valentina Mazzotta, Giovanni Guaraldi, Erica Franceschini, Marianna Meschiari, Loredana Sarmati, Andrea Antinori, Emanuele Nicastri, Cristina Mussini
INTRODUCTION: Casirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38528524/respiratory-entrainment-related-reverse-triggering-in-mechanically-ventilated-children
#12
JOURNAL ARTICLE
Robert G T Blokpoel, Ruben B R Brandsema, Alette A Koopman, Jefta van Dijk, Martin C J Kneyber
BACKGROUND: The underlying pathophysiological pathways how reverse triggering is being caused are not fully understood. Respiratory entrainment may be one of these mechanisms, but both terms are used interchangeably. We sought to characterize reverse triggering and the relationship with respiratory entrainment among mechanically ventilated children with and without acute lung injury. METHODS: We performed a secondary phyiology analysis of two previously published data sets of invasively mechanically ventilated children < 18 years with and without lung injury mechanically ventilated in a continuous or intermittent mandatory ventilation mode...
March 25, 2024: Respiratory Research
https://read.qxmd.com/read/38527543/3d-multi-robot-olfaction-in-naturally-ventilated-indoor-environments-locating-a-time-varying-source-at-unknown-heights
#13
JOURNAL ARTICLE
Mingrui Jiang, Chengxin Tong, Zhenfeng Li, Hao Cai, Canxin Zhang, Yue Shi, Hao Chen, Yan Tong
Source localization is significant for mitigating indoor air pollution and safeguarding the well-being and safety of occupants. While most study focuses on mechanical ventilation and static sources, this study explores the less-explored domain of locating time-varying sources in naturally ventilated spaces. We have developed an innovative 3D localization system that adjusts to varying heights, significantly enhancing capabilities beyond traditional fixed-height 2D systems. To ensure consistency in experimental conditions, we conducted comparative analyses of 2D and 3D methods, using a swinging fan to simulate natural ventilation...
March 23, 2024: Science of the Total Environment
https://read.qxmd.com/read/38526681/reinforcement-learning-for-intensive-care-medicine-actionable-clinical-insights-from-novel-approaches-to-reward-shaping-and-off-policy-model-evaluation
#14
JOURNAL ARTICLE
Luca F Roggeveen, Ali El Hassouni, Harm-Jan de Grooth, Armand R J Girbes, Mark Hoogendoorn, Paul W G Elbers
BACKGROUND: Reinforcement learning (RL) holds great promise for intensive care medicine given the abundant availability of data and frequent sequential decision-making. But despite the emergence of promising algorithms, RL driven bedside clinical decision support is still far from reality. Major challenges include trust and safety. To help address these issues, we introduce cross off-policy evaluation and policy restriction and show how detailed policy analysis may increase clinical interpretability...
March 25, 2024: Intensive Care Medicine Experimental
https://read.qxmd.com/read/38526489/physiologic-effects-of-ecmo-in-patients-with-severe-acute-respiratory-distress-syndrome
#15
JOURNAL ARTICLE
Elena Spinelli, Marco Giani, Douglas Slobod, Bertrand Pavlovsky, Michela di Pierro, Stefania Crotti, Alfredo Lissoni, Giuseppe Foti, Giacomo Grasselli, Tommaso Mauri
RATIONALE: Blood flow rate affects mixed venous oxygenation (SvO2 ) during venovenous extracorporeal membrane oxygenation (ECMO), with possible effects on the pulmonary circulation and the right heart function. OBJECTIVES: We aimed at describing the physiologic effects of different levels of SvO2 obtained by changing ECMO blood flow, in patients with severe ARDS receiving ECMO and controlled mechanical ventilation. METHODS: Low (SvO2 target 70-75%), intermediate (SvO2 target 75-80%) and high (SvO2 target > 80%) ECMO blood flows were applied for 30 minutes in random order in 20 patients...
March 25, 2024: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/38525926/venous-blood-gases-in-the-assessment-of-respiratory-failure-in-patients-undergoing-sleep-studies-a-randomized-study
#16
JOURNAL ARTICLE
Steven James Lindstrom, Christine Faye McDonald, Mark Erskine Howard, Fergal James O'Donoghue, Marcus Anthony McMahon, Linda Rautela, Thomas Churchward, Peter Biesenbach, Peter Douglas Rochford
STUDY OBJECTIVES: Venous blood gases (VBGs) are not consistently considered suitable surrogates for arterial blood gases (ABGs) in assessing acute respiratory failure due to variable measurement error. The physiological stability of patients with chronic ventilatory failure may lead to improved agreement in this setting. METHODS: Adults requiring ABGs for sleep or ventilation titration studies had VBGs drawn before or after each ABG, in a randomized order. Veno-arterial correlation and agreement were examined for carbon dioxide tension (PCO2 ), pH, oxygen tension (PO2 ) and oxygen saturation (SO2 )...
October 25, 2023: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://read.qxmd.com/read/38524091/retrospective-observational-study-to-assess-safety-and-tolerability-of-nebulized-colistin-for-the-treatment-of-patients-with-pneumonia-in-real-world-settings-in-respiratory-icu
#17
JOURNAL ARTICLE
Deepak Talwar, Deepak Prajapat, Surbhi Talwar, Dhruv Talwar
INTRODUCTION: Colistin is used to treat hospital-acquired pneumonia and ventilator-associated pneumonia. However, direct drug deposition at the site of infection may improve its efficacy and reduce systemic exposure. The aim of this study was to assess the safety and tolerability of nebulized colistin among Indian patients diagnosed with pneumonia caused by multidrug-resistant gram-negative bacilli in real-world settings. METHODOLOGY: We retrospectively reviewed the medical records of patients treated with nebulized colistin for pneumonia...
February 2024: Curēus
https://read.qxmd.com/read/38524082/the-delicate-dance-of-intraoperative-anesthesia-addressing-patient-and-anesthesiologist-concerns
#18
JOURNAL ARTICLE
Zaid Al Modanat, Lou'i Al-Husinat, Bashar M Mistarihi, Mohammad Tashtoush, Jood Alsarabi, Rama Matalqah, Hassan Mistarihi, Mohammad Wasfi Amir, Nawal Debajah, Esra'a Rejoub, Raneem Bereshy, Mustafa Tawaha, Rana Talj, Giustino Varrassi
Background In the realm of surgical procedures, patients and anesthesiologists have distinct concerns that can have an impact on their relationship. Patients are often riddled with anxiety about the unknowns of anesthesia and the possible risks. Anesthesiologists, too, face their own set of concerns. Despite the importance of this interaction, there has been little research on the specific concerns of both parties. Our study aims to fill this gap by describing and comparing the concerns of patients and anesthesiologists in Jordan...
February 2024: Curēus
https://read.qxmd.com/read/38522443/effectiveness-of-bubble-continuous-positive-airway-pressure-for-treatment-of-children-aged-1-59-months-with-severe-pneumonia-and-hypoxaemia-in-ethiopia-a-pragmatic-cluster-randomised-controlled-trial
#19
JOURNAL ARTICLE
Meseret Gebre, Kassa Haile, Trevor Duke, Md Tanveer Faruk, Mehnaz Kamal, Md Farhad Kabir, Md Fakhar Uddin, Muluye Shimelis, Tigist Beyene, Bethelhem Solomon, Meles Solomon, Abebe Genetu Bayih, Alemseged Abdissa, Taye Tolera Balcha, Rahel Argaw, Asrat Demtse, Abate Yeshidinber Weldetsadik, Abayneh Girma, Bitseat W Haile, Abu Sadat Mohammad Sayeem Bin Shahid, Tahmeed Ahmed, John D Clemens, Mohammod Jobayer Chisti
BACKGROUND: The safety and efficacy of bubble continuous positive airway pressure (bCPAP) for treatment of childhood severe pneumonia outside tertiary care hospitals is uncertain. We did a cluster-randomised effectiveness trial of locally made bCPAP compared with WHO-recommended low-flow oxygen therapy in children with severe pneumonia and hypoxaemia in general hospitals in Ethiopia. METHODS: This open, cluster-randomised trial was done in 12 general (secondary) hospitals in Ethiopia...
March 21, 2024: Lancet Global Health
https://read.qxmd.com/read/38522242/diagnostic-accuracy-of-prehospital-lung-ultrasound-for-acute-decompensated-heart-failure-a-systematic-review-and-meta-analysis
#20
REVIEW
Frances M Russell, Nicholas E Harrison, Oliver Hobson, Nicholas Montelauro, Cecelia J Vetter, Daniel Brenner, Sarah Kennedy, Benton R Hunter
BACKGROUND: Lung ultrasound (LUS) reduces time to diagnosis and treatment of acute decompensated heart failure (ADHF) in emergency department (ED) patients with undifferentiated dyspnea. We conducted a systematic review to evaluate the diagnostic accuracy and clinical impact of LUS for ADHF in the prehospital setting. METHODS: We performed a keyword search of multiple databases from inception through June 1, 2023. Included studies were those enrolling prehospital patients with undifferentiated dyspnea or suspected ADHF, and specifically diagnostic studies comparing prehospital LUS to a gold standard and intervention studies with a non-US comparator group...
March 18, 2024: American Journal of Emergency Medicine
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