Publications by authors named "J M Oropello"
Achieving adequate enteral nutrition among mechanically ventilated patients is challenging, yet critical. We developed NutriSighT, a transformer model using learnable positional coding to predict which patients would achieve hypocaloric nutrition between days 3-7 of mechanical ventilation. Using retrospective data from two large ICU databases (3,284 patients from AmsterdamUMCdb - development set, and 6,456 from MIMIC-IV - external validation set), we included adult patients intubated for at least 72 hours.
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- The study investigates how integrating point of care (POC) echocardiography in managing septic shock affects patient outcomes in the ICU following the Surviving Sepsis Campaign guidelines.
- A total of 1701 articles were reviewed, and after filtering, seven studies with 3885 patients were included, showing that POC echocardiography is linked to lower in-hospital and 28-day mortality rates, more frequent use of inotropic support, and faster lactate clearance.
- The researchers concluded that while POC echocardiography can improve some outcomes in septic shock management, more extensive studies are needed to confirm these findings and explore additional treatment effects.
Article Synopsis
- Intravenous fluids are crucial for managing acute kidney injury (AKI) after sepsis, but they can lead to fluid overload, prompting a need for a restrictive fluid strategy for certain patients.
- A machine learning algorithm was developed and validated to identify sepsis patients with AKI who would benefit from receiving less than 500mL of fluids within 24 hours.
- The algorithm suggested that 88.2% of patients in the validation cohort would benefit from a restrictive fluid approach, leading to higher rates of early and sustained AKI reversal and lower major adverse kidney events compared to those receiving more fluids.
Background: Arterial catheter placement for hemodynamic monitoring is commonly performed in critically ill patients. The radial and femoral arteries are the two sites most frequently used; there is limited data on the use of the axillary artery for this purpose. The aim of this study was to investigate the rate of complications from ultrasound-guided axillary artery catheter placement in critically ill patients.
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