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Objectives: To develop and externally validate an intubation prediction model for children admitted to a PICU using objective and routinely available data from the electronic medical records (EMRs).
Design: Retrospective observational cohort study.
Setting: Two PICUs within the same healthcare system: an academic, quaternary care center (36 beds) and a community, tertiary care center (56 beds).
Patients: Children younger than 18 years old admitted to a PICU between 2010 and 2022.
Interventions: None.
Measurements And Main Results: Clinical data was extracted from the EMR. PICU stays with at least one mechanical ventilation event (≥ 24 hr) occurring within a window of 1-7 days after hospital admission were included in the study. Of 13,208 PICU stays in the derivation PICU cohort, 1,175 (8.90%) had an intubation event. In the validation cohort, there were 1,165 of 17,841 stays (6.53%) with an intubation event. We trained a Categorical Boosting (CatBoost) model using vital signs, laboratory tests, demographic data, medications, organ dysfunction scores, and other patient characteristics to predict the need of intubation and mechanical ventilation using a 24-hour window of data within their hospital stay. We compared the CatBoost model to an extreme gradient boost, random forest, and a logistic regression model. The area under the receiving operating characteristic curve for the derivation cohort and the validation cohort was 0.88 (95% CI, 0.88-0.89) and 0.92 (95% CI, 0.91-0.92), respectively.
Conclusions: We developed and externally validated an interpretable machine learning prediction model that improves on conventional clinical criteria to predict the need for intubation in children hospitalized in a PICU using information readily available in the EMR. Implementation of our model may help clinicians optimize the timing of endotracheal intubation and better allocate respiratory and nursing staff to care for mechanically ventilated children.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932861 | PMC |
http://dx.doi.org/10.1097/PCC.0000000000003410 | DOI Listing |
Ann Otol Rhinol Laryngol
December 2024
Department of Otorhinolaryngology & Head-Neck Surgery, Medical College & Hospital, Kolkata; West Bengal, India.
Background: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; ) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.
Objectives: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.
Methods: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window).
Respir Res
December 2024
Department of Anesthesiology, Guangxi Medical University Cancer Hospital, He Di Rd No.71, Nanning, 530021, P. R. China.
Mechanical ventilation (MV) remains a cornerstone of critical care; however, its prolonged application can exacerbate lung injury, leading to ventilator-induced lung injury (VILI). Although previous studies have implicated ferroptosis in the pathogenesis of VILI, the underlying mechanisms remain unclear. This study investigated the roles of ferritinophagy in ferroptosis subsequent to VILI.
View Article and Find Full Text PDFJ Int Med Res
December 2024
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
Objective: To evaluate characteristics and outcomes in critically ill patients with Guillain-Barré syndrome (GBS).
Methods: Consecutive adults with GBS who required intensive care unit (ICU) admission at a tertiary-care hospital between 1999 and 2020 were enrolled into this retrospective cohort study. Demographics, clinical data and patient outcomes were compared between patients who did or did not receive mechanical ventilation (MV).
Eur J Cardiothorac Surg
December 2024
Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Objectives: In patients with interstitial lung disease (ILD), the diaphragm typically rises as the lungs chronically shrink. However, the grade of restriction differs in each patient. It is currently unknown, how disparities between actual and predicted recipient total lung capacity (TLC), impact changes in lung function parameters and long-term outcomes following lung transplantation (LTx).
View Article and Find Full Text PDFPediatr Surg Int
December 2024
Department of Pediatric Surgery, Karamanoğlu Mehmetbey University, Karaman, Türkiye.
Background: We aimed to evaluate the epidemiological characteristics, risk factors and prognostic factors affecting the clinical follow-up of patients who underwent tube thoracostomy due to pneumothorax in the neonatal intensive care unit of our hospital.
Methods: In our study; 54 cases with neonatal pneumothorax underwent tube thoracostomy followed up in the neonatal intensive care unit between April 2014 and March 2023 were retrospectively analyzed.
Results: The gestational age of the cases was between 28 and 38 weeks; 24 (44.
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