Evidence map›Paper›PMID 34330255›Full record

ArticleBMC medical informatics and decision making2021

Selection strategy for sedation depth in critically ill patients on mechanical ventilation.

Longxiang Su, Chun Liu, Fengxiang Chang, Bo Tang, Lin Han, Huizhen Jiang, Weiguo Zhu, Na Hong, Xiang Zhou, Yun Long

Open access · goldAbstract read
In one paragraph

Article in BMC medical informatics and decision making, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Longxiang Su *Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Chun Liu *Digital Health China Technologies Co. Ltd., Floor 19, China Technology Exchange Building, 66 West Beisihuan Road, Haidian District, Beijing, 100080, China.
Fengxiang Chang *Digital Health China Technologies Co. Ltd., Floor 19, China Technology Exchange Building, 66 West Beisihuan Road, Haidian District, Beijing, 100080, China.
Bo TangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Lin HanDigital Health China Technologies Co. Ltd., Floor 19, China Technology Exchange Building, 66 West Beisihuan Road, Haidian District, Beijing, 100080, China.
Huizhen JiangInformation Center Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Weiguo ZhuInformation Center Department/Department of Information Management, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Na HongDigital Health China Technologies Co. Ltd., Floor 19, China Technology Exchange Building, 66 West Beisihuan Road, Haidian District, Beijing, 100080, China. hongna@dchealth.com.
Xiang ZhouDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. zx_pumc@163.com.
Yun LongDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. ly_icu@aliyun.com.ORCID 0000-0001-6798-1761
Chinese Academy of Medical Sciences & Peking Union Medical College · CNDigital China Health (China) · CN

Funding

Beijing Nova Program from Beijing Municipal Science & Technology Commission Z201100006820126Capital Characteristic Clinic Project of Beijing Z181100001718209China Health Information and Health Care Big Data Association Severe Infection Analgesia and Sedation Big Data Special Fund Z-2019-1-001China International Medical Exchange Foundation Special Fund for Young and Middle-aged Medical Research Z-2018-35-1902Undergraduate Teaching Reform of Peking Union Medical College Hospital 2020zlgc0109
6 · The paper itself

Abstract

backgroundAnalgesia and sedation therapy are commonly used for critically ill patients, especially mechanically ventilated patients. From the initial nonsedation programs to deep sedation and then to on-demand sedation, the understanding of sedation therapy continues to deepen. However, according to different patient's condition, understanding the individual patient's depth of sedation needs remains unclear.

methodsThe public open source critical illness database Medical Information Mart for Intensive Care III was used in this study. Latent profile analysis was used as a clustering method to classify mechanically ventilated patients based on 36 variables. Principal component analysis dimensionality reduction was used to select the most influential variables. The ROC curve was used to evaluate the classification accuracy of the model.

resultsBased on 36 characteristic variables, we divided patients undergoing mechanical ventilation and sedation and analgesia into two categories with different mortality rates, then further reduced the dimensionality of the data and obtained the 9 variables that had the greatest impact on classification, most of which were ventilator parameters. According to the Richmond-ASS scores, the two phenotypes of patients had different degrees of sedation and analgesia, and the corresponding ventilator parameters were also significantly different. We divided the validation cohort into three different levels of sedation, revealing that patients with high ventilator conditions needed a deeper level of sedation, while patients with low ventilator conditions required reduction in the depth of sedation as soon as possible to promote recovery and avoid reinjury.

conclusionThrough latent profile analysis and dimensionality reduction, we divided patients treated with mechanical ventilation and sedation and analgesia into two categories with different mortalities and obtained 9 variables that had the greatest impact on classification, which revealed that the depth of sedation was limited by the condition of the respiratory system.

Indexed as

AnesthesiaRespiration, ArtificialCritical CareCritical IllnessHumansIntensive Care UnitsPain ManagementClusteringICULatent profile analysisMechanical ventilationSedation and analgesia

Identifiers

PMID34330255
PMCPMC8322830
OpenAlexW3183413516

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.