Unlabelled: Unexpected ICU readmission is associated with longer length of stay and increased mortality. To prevent ICU readmission and death after ICU discharge, our team of intensivists and data scientists aimed to use AmsterdamUMCdb to develop an explainable machine learning-based real-time bedside decision support tool.
Derivation Cohort: Data from patients admitted to a mixed surgical-medical academic medical center ICU from 2004 to 2016.
Objectives: Critical care medicine is a natural environment for machine learning approaches to improve outcomes for critically ill patients as admissions to ICUs generate vast amounts of data. However, technical, legal, ethical, and privacy concerns have so far limited the critical care medicine community from making these data readily available. The Society of Critical Care Medicine and the European Society of Intensive Care Medicine have identified ICU patient data sharing as one of the priorities under their Joint Data Science Collaboration.
View Article and Find Full Text PDFIntroduction: Antibiotic dosing in critically ill patients is challenging because their pharmacokinetics (PK) are altered and may change rapidly with disease progression. Standard dosing frequently leads to inadequate PK exposure. Therapeutic drug monitoring (TDM) offers a potential solution but requires sampling and PK knowledge, which delays decision support.
View Article and Find Full Text PDFPurpose: We wanted to identify modifiable risk factors for intensive care unit (ICU)-acquired hypernatremia.
Materials And Methods: We retrospectively studied sodium and fluid loads and balances up to 7 days prior to the development of hypernatremia (first serum sodium concentration, [Na+], >150 mmol/L; H) vs control (maximum [Na+] ≤150 mmol/L; N), in consecutive patients admitted into the ICU with a normal serum sodium (<145 mmol/L) and without cerebral disease, within a period of 8 months.
Results: There were 57 H and 150 N patients.
Introduction: Mild therapeutic hypothermia (MTH) is a worldwide used therapy to improve neurological outcome in patients successfully resuscitated after cardiac arrest (CA). Preclinical data suggest that timing and speed of induction are related to reduction of secondary brain damage and improved outcome.
Methods: Aiming at a rapid induction and stable maintenance phase, MTH induced via continuous peritoneal lavage (PL) using the Velomedix Inc.
Background: Optimal nutrition for patients in the intensive care unit has been proposed to be the provision of energy as determined by indirect calorimetry and the provision of protein of at least 1.2 g/kg.
Methods: Prospective observational cohort study in a mixed medical-surgical intensive care unit in an academic hospital.