Journal of critical care
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Journal of critical care · Dec 2020
Supervised machine learning for the early prediction of acute respiratory distress syndrome (ARDS).
Acute respiratory distress syndrome (ARDS) is a serious respiratory condition with high mortality and associated morbidity. The objective of this study is to develop and evaluate a novel application of gradient boosted tree models trained on patient health record data for the early prediction of ARDS. ⋯ Supervised machine learning predictions may help predict patients with ARDS up to 48 h prior to onset.
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Journal of critical care · Dec 2020
Observational StudyThe ability of Procalcitonin, lactate, white blood cell count and neutrophil-lymphocyte count ratio to predict blood stream infection. Analysis of a large database.
The global burden of death due to sepsis is considerable. Early diagnosis is essential to improve the outcome of this deadly syndrome. Yet, the diagnosis of sepsis is fraught with difficulties. Patients with blood stream infection (BSI) are at an increased risk of complications and death. The aim of this study was to determine the diagnostic accuracy of four readily available biomarkers to diagnose BSI in patients with suspected sepsis. ⋯ Our results suggest that PCT of less than 0.5 ng/mL may be an effective screening tool to exclude BSI as the cause of sepsis, while the diagnosis of BSI should be considered in patients with a PCT above this threshold. The total WBC count and blood lactate concentration may not be reliable biomarkers for the diagnosis of BSI. The NLCR may be a useful screening test for BSI when PCT assays are not available.
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Journal of critical care · Dec 2020
LetterRenal replacement therapy in critically ill patients with COVID-19: A retrospective study investigating mortality, renal recovery and filter lifetime.
This study aims to investigate mortality and renal recovery in patients with Acute Kidney Injury (AKI) and Renal Replacement Therapy (RRT) due to COVID-19. A secondary aim is to investigate the filter life time in Continuous VenoVenous Hemofiltration (CVVH) and the effect of different methods of anticoagulation. ⋯ The need for RRT in critically ill patients with COVID-19 was reversible in our cohort and RRT was not associated with an increased mortality compared to AKI without the need for RRT. Higher levels of anticoagulation were not associated with prolonged filter life.