The Effect of Aromatherapy Application on the Vital Signs of Intensive Care Patients

Critical care staff are presented with a large amount of data, which made it difficult to systematically evaluate. Early detection of patients whose condition is deteriorating could reduce mortality, improve treatment outcomes, and allow a better use of healthcare resources. In this study, we propose a data-driven framework for predicting the risk of mortality that combines high-accuracy recurrent neural networks with interpretable explanations. Our model processes time-series of vital signs and laboratory observations to predict the probability of a patient’s mortality in the intensive care unit (ICU). We investigated our approach on three public critical care databases: Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III), MIMIC-IV, and eICU. Our models achieved an area under the receiver operating characteristic curve (AUC) of 0.87–0.91. Our approach was not only able to provide the predicted mortality risk but also to recognize and explain the historical contributions of the associated factors to the prediction. The explanations provided by our model were consistent with the literature. Patients may benefit from early intervention if their clinical observations in the ICU are continuously monitored in real time.

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Vital signs of severe COVID-19 patients during inter-hospital helicopter transfer

10.21203/rs.3.rs-1203192/v1 ◽

2021 ◽

Author(s):

Cornelis Slagt ◽

Eduard Johannes Spoelder ◽

Marijn Cornelia Theresia Tacken ◽

Maartje Frijlink ◽

Sjoerd Servaas ◽

...

Keyword(s):

Cardiac Output ◽

Intensive Care ◽

The Netherlands ◽

Stroke Volume ◽

Critically Ill ◽

Systemic Vascular Resistance ◽

Vital Signs ◽

Intensive Care Patients ◽

Non Invasive ◽

The Impact

Abstract Background: During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were not only transferred between hospitals by ambulance, but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the impact of helicopter transport on critically ill patients, and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated severe COVID-19 intensive care patients, with special focus on take-off, midflight, and landing. Methods: All ventilated critically ill COVID-19 patients who were transported between April 2020 and June 2021 by the Dutch ‘Lifeliner 5’ HEMS team and who were fully monitored including non-invasive cardiac output, were included in this study. Three 10 minute timeframes (take-off, midflight and landing) were defined for analysis. Continuous data of vital parameters heartrate, peripheral oxygen saturation, arterial blood pressure, end-tidal CO2 and non-invasive cardiac output using electrical cardiometry were collected and stored at a 1 minute interval. Data were analysed for differences over time within the timeframes using 1-way analysis of variance. Significant differences were checked for clinical relevance. Results: Ninety-eight patients were included in the analysis. During take-off an increase was noticed in cardiac output (from 6.7 to 8.1 Lmin-1; P<0.0001) which was determined by a decrease in systemic vascular resistance (from 1068 to 750 dyne·s·cm−5, P<0.0001) accompanied by an increase in stroke volume (from 92.0 to 110.2 ml, P<0.0001). Other parameters were unchanged during take-off and mid-flight. During the landing cardiac output and stroke volume slightly decreased (from 7.9 to 7.1 Lmin-1, P<0.0001 and from 108.3 to 100.6 ml, P<0.0001 respectively) and total systemic vascular resistance increased (P<0.0001). Though statistically significant, the found changes were small and not clinically relevant to the medical status of the patients as judged by the attending physicians. Conclusions: Interhospital helicopter transfer of ventilated intensive care patients with COVID-19 can be performed safely and does not result in clinically relevant changes in vital signs. This study this has been assessed by the medical ethical committee Arnhem-Nijmegen, the Netherlands (identifier 2021-7313). The committee waived the need for informed consent. The study was registered at www.trialregister.nl (identifier NL9307).

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Classification of COVID-19 in intensive care patients: towards rational and effective triage

10.1101/2020.04.09.20058909 ◽

2020 ◽

Author(s):

Xiaofan Lu ◽

Yang Wang ◽

Taige Chen ◽

Yongsheng Li ◽

Jun Wang ◽

...

Keyword(s):

Intensive Care ◽

Latent Variable ◽

Inflammatory Marker ◽

Vital Signs ◽

General Information ◽

Disease Classification ◽

Variable Model ◽

Intensive Care Patients ◽

Fully Bayesian

The number of pertinent researches of COVID-19 has increased rapidly but they mainly focused on the description of general information of patients with confirmed infection. We aimed to bridge the gap between disease classification and clinical outcome in intensive care patients, data of which are scarce and such classification could help in individual evaluation and provide effective triage for treatment and management. Specifically, we collected and filtered out 151 intensive care patients with complete medical records from Tongji hospital in Wuhan, China. We constructed a fully Bayesian latent variable model for integrative clustering of six data categories, including demographic information, symptoms, original comorbidities, vital signs, blood routine tests and inflammatory marker measurements. We identified four prognostic types of COVID-19 in intensive care patients, presenting a stepwise distribution in age, respiratory condition and inflammatory markers, suggesting the prognostic efficacy of these indicators. This report, to our knowledge, is the first attempt of dealing with classification of COVID-19 in intensive care patients. We acknowledge the limitation of ignoring the effect of treatment, but we believe such classification is enlightening for better triage, allowing for a more rational allocation of scarce medical resources in a resource constrained environment.

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Vital signs of severe COVID-19 patients during inter-hospital helicopter transfer

10.21203/rs.3.rs-1203192/v2 ◽

2022 ◽

Author(s):

Cornelis Slagt ◽

Eduard Johannes Spoelder ◽

Marijn Cornelia Theresia Tacken ◽

Maartje Frijlink ◽

Sjoerd Servaas ◽

...

Keyword(s):

Cardiac Output ◽

Intensive Care ◽

The Netherlands ◽

Stroke Volume ◽

Critically Ill ◽

Systemic Vascular Resistance ◽

Vascular Resistance ◽

Vital Signs ◽

Intensive Care Patients ◽

The Impact

Abstract Background: During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were transferred not only between hospitals by ambulance but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the impact of helicopter transport on critically ill patients and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated severe COVID-19 intensive care patients, with special focus on take-off, midflight, and landing.Methods: All ventilated critically ill COVID-19 patients who were transported between April 2020 and June 2021 by the Dutch ‘Lifeliner 5’ HEMS team and who were fully monitored, including noninvasive cardiac output, were included in this study. Three 10-minute timeframes (take-off, midflight and landing) were defined for analysis. Continuous data on the vital parameters heart rate, peripheral oxygen saturation, arterial blood pressure, end-tidal CO2 and noninvasive cardiac output using electrical cardiometry were collected and stored at 1-minute intervals. Data were analydzed for differences over time within the timeframes using 1-way analysis of variance. Significant differences were checked for clinical relevance.Results: Ninety-eight patients were included in the analysis. During take-off, an increase was noticed in cardiac output (from 6.7 to 8.1 Lmin-1; P<0.0001), which was determined by a decrease in systemic vascular resistance (from 1068 to 750 dyne·s·cm−5, P<0.0001) accompanied by an increase in stroke volume (from 92.0 to 110.2 ml, P<0.0001). Other parameters were unchanged during take-off and mid-flight. During landing, cardiac output and stroke volume slightly decreased (from 7.9 to 7.1 Lmin-1, P<0.0001 and from 108.3 to 100.6 ml, P<0.0001, respectively), and total systemic vascular resistance increased (P<0.0001). Though statistically significant, the found changes were small and not clinically relevant to the medical status of the patients as judged by the attending physicians.Conclusions: Interhospital helicopter transfer of ventilated intensive care patients with COVID-19 can be performed safely and does not result in clinically relevant changes in vital signs.This study was assessed by the medical ethical committee Arnhem-Nijmegen, the Netherlands (identifier 2021-7313). The committee waived the need for informed consent. The study was registered at www.trialregister.nl (identifier NL9307).

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