A digital-twin based three-tiered system is proposed to prioritise patients for urgent intensive care and ventilator support. The deep learning methods are used to build patient-specific digital-twins to identify and prioritise critical cases amongst severe pneumonia patients. The three-tiered strategy is proposed to generate severity indices to: (1) identify urgent cases, (2) assign critical care and mechanical ventilation, and (3) discontinue mechanical ventilation and critical care at the optimal time. The severity indices calculated in the present study are the probability of death and the probability of requiring mechanical ventilation. These enable the generation of patient prioritisation lists and facilitates the smooth flow of patients in and out of Intensive Therapy Units (ITUs). The proposed digital-twin is built on pre-trained deep learning models using data from more than 1895 pneumonia patients. The severity indices calculated in the present study are assessed using the standard benchmark of Area Under Receiving Operating Characteristic Curve (AUROC). The results indicate that the ITU and mechanical ventilation can be prioritised correctly to an AUROC value as high as 0.89. This model may be employed in its current form to COVID-19 patients, but transfer learning with COVID-19 patient data will improve the predictions. The digital-twin model developed and tested is available via accompanying Supplemental material.
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http://dx.doi.org/10.1177/09544119221123431 | DOI Listing |
Ann Hematol
January 2025
Internal Medicine- Wayne State University School of Medicine, Rochester Hills, Michigan, USA.
The "obesity paradox" suggests that, despite a higher baseline risk for adverse health outcomes, obese patients can experience a lower complication and mortality rate in conditions such as pulmonary embolisms (PE). This study aims to examine the association between obesity and inpatient outcomes of PE patients, utilizing the data from the National Inpatient Sample (NIS) database. We conducted a retrospective study analysis of obese adult PE patients (aged ≥ 18) using the NIS database from 2016 to 2020.
View Article and Find Full Text PDFHeart Lung
January 2025
College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Ministry of the National Guard Health Affairs Riyadh, Saudi Arabia; Medical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt.
Background: Endotracheal intubation and mechanical ventilation comprise common life support interventions for patients in intensive care units (ICUs). Premature or delayed extubation increases the risk of morbidity and mortality. Despite following weaning protocols, 10-20 % of patients fail extubation within 48 h.
View Article and Find Full Text PDFJ Crit Care
January 2025
Hospital Saint-Louis et Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France. Electronic address:
Purpose: Onco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs).
Methods: This multicenter retrospective study included 214 OH patients with CS across 22 ICUs (2010-2021).
Am J Emerg Med
January 2025
Departments of Emergency Medicine and Critical Care Medicine, Stanford Health Care, 900 Welch Road, Palo Alto, CA 94304, USA.
Background: Critically ill ED patients on life support may undergo transition to comfort care as decided by the surrogate decision maker. When several hours are needed for loved ones to arrive and say farewell before initiating comfort care ("delayed comfort care"), these patients require prolonged ED stays or costly intensive care unit (ICU) admissions.
Methods: A novel ED observation unit (EDOU)-based delayed comfort care pathway for ED patients on invasive mechanical ventilation and/or vasopressors was created in 2013 at Stanford Hospital.
Resuscitation
January 2025
Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Haus 808, Kiel, 24105, Schleswig-Holstein, Germany; Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, Graz, 8036, Styria, Austria. Electronic address:
Manual and mechanical ventilation during cardiopulmonary resuscitation are critical yet poorly understood components of resuscitation care. In recent years, intra-arrest ventilation has been the subject of a growing number of laboratory and clinical investigations. Essential components to accurately interpret or reproduce original investigations are the exact measurement and transparent reporting of key ventilation parameters, such as volumes and airway pressures obtained during ongoing cardiopulmonary resuscitation.
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