Abstract:
OBJECTIVE:Predictive analytics monitoring that informs clinicians of the risk for failed extubation would help minimize both the duration of mechanical ventilation and the risk of emergency re-intubation in ICU patients. We hypothesized that dynamic monitoring of cardiorespiratory data, vital signs, and lab test results would add information to standard clinical risk factors. METHODS:We report model development in a retrospective observational cohort admitted to either the medical or surgical/trauma ICU that were intubated during their ICU stay and had available physiologic monitoring data (n = 1202). The primary outcome was removal of endotracheal intubation (i.e. extubation) followed within 48 h by reintubation or death (i.e. failed extubation). We developed a standard risk marker model based on demographic and clinical data. We also developed a novel risk marker model using dynamic data elements-continuous cardiorespiratory monitoring, vital signs, and lab values. RESULTS:Risk estimates from multivariate predictive models in the 24 h preceding extubation were significantly higher for patients that failed. Combined standard and novel risk markers demonstrated good predictive performance in leave-one-out validation: AUC of 0.64 (95% CI: 0.57-0.69) and 1.6 alerts per week to identify 32% of extubations that will fail. Novel risk factors added significantly to the standard model. CONCLUSION:Predictive analytics monitoring models can detect changes in vital signs, continuous cardiorespiratory monitoring, and laboratory measurements in both the hours preceding and following extubation for those patients destined for extubation failure.
journal_name
Physiol Measjournal_title
Physiological measurementauthors
Keim-Malpass J,Enfield KB,Calland JF,Lake DE,Clark MTdoi
10.1088/1361-6579/aace95subject
Has Abstractpub_date
2018-07-16 00:00:00pages
075005issue
7eissn
0967-3334issn
1361-6579journal_volume
39pub_type
杂志文章abstract::The effects of mechanical stimulation on hemodynamics, such as due to mechanotransduction in vascular endothelial cells, have been widely discussed recently. We previously proposed a resonance model in which the arterial system is treated as a pressure-transmitting system, and suggested that the application of externa...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/27/2/004
更新日期:2006-02-01 00:00:00
abstract::The purpose of this study was to determine the validity and reliability of a timed 5 km cycle ergometer ride to predict maximum oxygen uptake (VO2max). Fifty-two healthy volunteers had their VO2max determined during a maximal treadmill run. They also performed a timed 5 km cycle ergometer ride. The resistance setting ...
journal_title:Physiological measurement
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1088/0967-3334/17/4/009
更新日期:1996-11-01 00:00:00
abstract::The left atrium (LA) plays an important role in the maintenance of hemodynamic and electrical stability of the heart. One of the conditions altering the atrial mechanical function is atrial fibrillation (AF), leading to an increased thromboembolic risk due to impaired mechanical function. Preserving the regions of the...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/35/5/763
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:Doppler ultrasound (US) is the most commonly applied method to measure the fetal heart rate (fHR). When the fetal heart is not properly located within the ultrasonic beam, fHR measurements often fail. As a consequence, clinical staff need to reposition the US transducer on the maternal abdomen, which can be a...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/aa8a1a
更新日期:2017-09-21 00:00:00
abstract::Non-contact vital sign monitoring enables the estimation of vital signs, such as heart rate, respiratory rate and oxygen saturation (SpO2), by measuring subtle color changes on the skin surface using a video camera. For patients in a hospital ward, the main challenges in the development of continuous and robust non-co...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab525c
更新日期:2019-12-02 00:00:00
abstract::Dual-energy x-ray absorptiometry (DXA) is a precise, widely used method for measuring bone mineral density (BMD), usually of the lumbar spine and femoral neck. Recent developments, such as a lower x-ray tube current and pixel by pixel analysis, enable smaller bones and thinner tissues volumes, as in the hand, to be me...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/18/3/008
更新日期:1997-08-01 00:00:00
abstract::In this paper a description is given of the development, characterisation and first results of a thermal imaging device aimed at significantly reducing the incidence of diabetic foot ulceration (DFU). These devices will be used in three clinical centres and in two preliminary clinical trials. The first will be on heal...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/aa56b1
更新日期:2017-03-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/17/4a/026
更新日期:1996-11-01 00:00:00
abstract::Changes of the heart autonomic balance between morning (8-9 h) and afternoon (14-15 h) measurements were studied in 22 healthy subjects. The selection of these two daytime periods was substantiated by the established higher risk of cardiovascular incidents in the morning and the relative balance of the vegetative nerv...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/24/3/309
更新日期:2003-08-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/aa7256
更新日期:2017-07-24 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab37db
更新日期:2019-09-03 00:00:00
abstract::Vital signs monitoring is ubiquitous in clinical environments and emerging in home-based healthcare applications. Still, since current monitoring methods require uncomfortable sensors, respiration rate remains the least measured vital sign. In this paper, we propose a video-based respiration monitoring method that aut...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/37/1/100
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:An artefact-free electrocardiogram (ECG) is essential during cardiac arrest to decide therapy such as defibrillation. Mechanical cardiopulmonary resuscitation (CPR) devices cause movement artefacts that alter the ECG. This study analyzes the effectiveness of mechanical CPR artefact suppression filters to rest...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab9e53
更新日期:2020-11-06 00:00:00
abstract::A method is described that accounts for multichannel brain field data (EEG) epochs, after transformation into the frequency domain, by a single oscillating dipole source in terms of phase angles. The method produces a potential distribution for each frequency point ('FFT dipole approximation'). These maps can be subje...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/14/4a/004
更新日期:1993-11-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/aba07b
更新日期:2020-08-11 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab924b
更新日期:2020-07-09 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/abc8dd
更新日期:2021-01-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab9376
更新日期:2020-07-02 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab6f52
更新日期:2020-03-06 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/29/12/004
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab921e
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/20/3/304
更新日期:1999-08-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/ab3493
更新日期:2019-11-04 00:00:00
abstract::Electrical impedance tomography (EIT) could be used as a portable non-invasive means to image the development of ischaemic stroke or haemorrhage. The purpose of this study was to examine if this was possible using time difference imaging, in the anesthetised rat using 40 spring-loaded scalp electrodes with applied con...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/37/6/765
更新日期:2016-06-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/30/3/006
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:The ventilators involved in non-invasive mechanical ventilation commonly provide ventilator support via a facemask. The interface of the mask with a patient promotes air leaks that cause errors in the feedback information provided by a pneumatic sensor and hence patient-ventilator asynchrony with multiple neg...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/1361-6579/aab7ac
更新日期:2018-04-26 00:00:00
abstract::Electrical impedance tomography (EIT) is a recent imaging technique based on electrical impedance, offering the possibility of measuring pulmonary perfusion. In the present study the influence of several pulmonary haemodynamical parameters on the EIT signal were investigated. First, the influence on the systolic wave ...
journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/19/2/013
更新日期:1998-05-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
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更新日期:1994-02-01 00:00:00
abstract::Impedance cardiography (ICG) has been proposed to estimate the stroke volume (SV) and cardiac output (CO) in various medical indications. The aim of this study was to explore the reliability of ICG during pregnancy with respect to SV and CO measurements. Blood pressure, heart rate and thoracic impedance were monitored...
journal_title:Physiological measurement
pub_type: 杂志文章
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更新日期:2012-06-01 00:00:00
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journal_title:Physiological measurement
pub_type: 杂志文章
doi:10.1088/0967-3334/34/11/1513
更新日期:2013-11-01 00:00:00