Mechanical ventilator plays a vital role in saving millions of lives. Patients with COVID-19 symptoms need a ventilator to survive during the pandemic. Studies have reported that the mortality rates rise from 50% to 97% in those requiring mechanical ventilation during COVID-19. The pumping of air into the patient's lungs using a ventilator requires a particular air pressure. High or low ventilator pressure can result in a patient's life loss as high air pressure in the ventilator causes the patient lung damage while lower pressure provides insufficient oxygen. Consequently, precise prediction of ventilator pressure is a task of great significance in this regard. The primary aim of this study is to predict the airway pressure in the ventilator respiratory circuit during the breath. A novel hybrid ventilator pressure predictor (H-VPP) approach is proposed. The ventilator exploratory data analysis reveals that the high values of lung attributes R and C during initial time step values are the prominent causes of high ventilator pressure. Experiments using the proposed approach indicate H-VPP achieves a 0.78 R, mean absolute error of 0.028, and mean squared error of 0.003. These results are better than other machine learning and deep learning models employed in this study. Extensive experimentation indicates the superior performance of the proposed approach for ventilator pressure prediction with high accuracy. Furthermore, performance comparison with state-of-the-art studies corroborates the superior performance of the proposed approach.
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http://dx.doi.org/10.1177/14604582241295912 | DOI Listing |
Crit Care
March 2025
Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Rationale: There are several approaches to select the optimal positive end-expiratory pressure (PEEP), resulting in different PEEP levels. The impact of different PEEP settings may extend beyond respiratory mechanics, affecting pulmonary hemodynamics.
Objectives: To compare PEEP levels obtained with three titration strategies-(i) highest respiratory system compliance (C), (ii) electrical impedance tomography (EIT) crossing point; (iii) positive end-expiratory transpulmonary pressure (P)-in terms of regional respiratory mechanics and pulmonary hemodynamics.
J Intensive Care
March 2025
Department of Anaesthesiology and Critical Care, AIIMS, Jodhpur, India.
We commend the authors for their insightful study on inspiratory muscle training (IMT) in mechanically ventilated patients with difficult weaning, highlighting the robust use of maximum inspiratory pressure (MIP) as a key outcome. We suggest that a lower baseline maximum inspiratory pressure cutoff could better target patients with significant inspiratory dysfunction, improving the study's precision. Additionally, alternative imputation techniques, such as multiple imputation, could strengthen the handling of missing data.
View Article and Find Full Text PDFClin Nutr ESPEN
March 2025
Nutrition and Dietetics Division, Hospital de Clínicas de Porto Alegre, Brazil. Electronic address:
Background: This study aimed to describe nutritional therapy and clinical outcomes in critically ill patients with coronavirus disease (COVID-19) hospitalized in an intensive care unit, submitted or not to the prone position.
Methods: This retrospective cohort study included adult patients with COVID-19 admitted to the intensive care unit (ICU) of a public university hospital from June to December 2020. Sociodemographic, clinical, nutritional, and anthropometric data were collected in electronic medical records with a prestructured collection instrument.
J Infect Dev Ctries
February 2025
Department of Nursing, Air Force Medical University, No. 169 Changle West Road, Xi'an 710032, Shaanxi Province, China.
Introduction: Noninvasive respiratory support (NIRS) using helmet devices is an emerging treatment for acute respiratory failure in patients with coronavirus disease 2019 (COVID-19). However, the comparative efficacy of helmet NIRS versus other strategies in this context remains elusive.
Methodology: A network meta-analysis was conducted to compare the efficacy of various NIRS strategies in randomized controlled trials (RCTs) involving COVID-19 patients with acute respiratory failure.
World J Gastroenterol
February 2025
Department of Neurosurgery, University of Flordia, Gainesville, FL 32608, United States.
Neurosurgical patients, including those with severe traumatic brain injury, spinal cord injury, stroke, or raised intracranial pressure, are at heightened risk for stress ulcers and aspiration pneumonitis, leading to significant morbidity and mortality. These patients are typically managed through both pharmacological interventions [, proton pump inhibitors (PPIs), histamine 2 (H2) antagonists, sucralfate] and non-pharmacological measures (, nasogastric decompression, patient positioning) to mitigate adverse outcomes. The pathogenesis of stress ulcers in neurosurgical patients is multifactorial, but the routine use of stress ulcer prophylaxis remains controversial.
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