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为呼吸护理中心的患者开发用于机械通气成功撤机最佳时机预测的交互式人工智能系统。

Development of an Interactive AI System for the Optimal Timing Prediction of Successful Weaning from Mechanical Ventilation for Patients in Respiratory Care Centers.

作者信息

Liao Kuang-Ming, Ko Shian-Chin, Liu Chung-Feng, Cheng Kuo-Chen, Chen Chin-Ming, Sung Mei-I, Hsing Shu-Chen, Chen Chia-Jung

机构信息

Department of Pulmonary Medicine, Chi Mei Medical Center, Chiali, Tainan 72263, Taiwan.

Department of Respiratory Therapy, Chi Mei Medical Center, Tainan 710402, Taiwan.

出版信息

Diagnostics (Basel). 2022 Apr 13;12(4):975. doi: 10.3390/diagnostics12040975.

Abstract

Successful weaning from prolonged mechanical ventilation (MV) is an important issue in respiratory care centers (RCCs). Delayed or premature extubation increases both the risk of adverse outcomes and healthcare costs. However, the accurate evaluation of the timing of successful weaning from MV is very challenging in RCCs. This study aims to utilize artificial intelligence algorithms to build predictive models for the successful timing of the weaning of patients from MV in RCCs and to implement a dashboard with the best model in RCC settings. A total of 670 intubated patients in the RCC in Chi Mei Medical Center were included in the study. Twenty-six feature variables were selected to build the predictive models with artificial intelligence (AI)/machine-learning (ML) algorithms. An interactive dashboard with the best model was developed and deployed. A preliminary impact analysis was then conducted. Our results showed that all seven predictive models had a high area under the receiver operating characteristic curve (AUC), which ranged from 0.792 to 0.868. The preliminary impact analysis revealed that the mean number of ventilator days required for the successful weaning of the patients was reduced by 0.5 after AI intervention. The development of an AI prediction dashboard is a promising method to assist in the prediction of the optimal timing of weaning from MV in RCC settings. However, a systematic prospective study of AI intervention is still needed.

摘要

从长期机械通气(MV)中成功撤机是呼吸护理中心(RCCs)的一个重要问题。延迟或过早拔管会增加不良后果的风险和医疗成本。然而,在RCCs中,准确评估从MV成功撤机的时机非常具有挑战性。本研究旨在利用人工智能算法建立预测模型,以预测RCCs中患者从MV成功撤机的时机,并在RCC环境中使用最佳模型实现一个仪表板。奇美医学中心RCC的670名插管患者被纳入研究。选择了26个特征变量,使用人工智能(AI)/机器学习(ML)算法建立预测模型。开发并部署了具有最佳模型的交互式仪表板。然后进行了初步影响分析。我们的结果表明,所有七个预测模型在受试者工作特征曲线(AUC)下的面积都很高,范围从0.792到0.868。初步影响分析显示,人工智能干预后,患者成功撤机所需的平均呼吸机天数减少了0.5天。开发人工智能预测仪表板是一种很有前景的方法,可协助预测RCC环境中从MV撤机的最佳时机。然而,仍需要对人工智能干预进行系统的前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e85/9030191/e639f65f7764/diagnostics-12-00975-g001.jpg

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