Prediction and simulation of PEEP setting effects with machine learning models
Medicina Intensiva(2024)
摘要
Objective
To establish a new machine learning-based method to adjust positive end-expiratory pressure (PEEP) using only already routinely measured data.
Design
Retrospective observational study.
Setting
Intensive care unit (ICU).
Patients or participants
51811 mechanically ventilated patients in multiple ICUs in the USA (data from MIMIC-III and eICU databases).
Interventions
No interventions.
Main variables of interest
Success parameters of ventilation (arterial partial pressures of oxygen and carbon dioxide and respiratory system compliance)
Results
The multi-tasking neural network model performed significantly best for all target tasks in the primary test set. The model predicts arterial partial pressures of oxygen and carbon dioxide and respiratory system compliance about 45 min into the future with mean absolute percentage errors of about 21.7%, 10.0% and 15.8%, respectively. The proposed use of the model was demonstrated in case scenarios, where we simulated possible effects of PEEP adjustments for individual cases.
Conclusions
Our study implies that machine learning approach to PEEP titration is a promising new method which comes with no extra cost once the infrastructure is in place. Availability of databases with most recent ICU patient data is crucial for the refinement of prediction performance.
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关键词
Machine learning,Neural network models,Mechanical ventilation,Intensive care units,Aprendizaje automático,Modelos de redes neuronales,Ventilación mecánica,Unidades de cuidados intensivos
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