Research progress on identification of acute respiratory distress syndrome based on noninvasive parameters / 医疗卫生装备

The concept and pathogenesis of acute respiratory distress syndrome (ARDS)were introduced,and the methods for identifying ARDS based on noninvasive parameters in recent years were retrospectively reviewed including regression method, nonlinear fitting method and multi parameter method.The above methods had their advantages and disadvantages summarized. It's suggested that multi noninvasive parameters and machine learning algorithms such as neural network, support vector machine and decision tree be involved in model construction to promote PaO2/FiO2assessment based on noninvasive parameters,so that the rapid diagnosis and real-time monitoring of ARDS can be realized based on noninvasive parameters while there were no need for blood gas analysis.

ARDS severity identification based on noninvasive parameter SpO2/FiO2 / 医疗卫生装备

Objective To explore the relationship between SpO2/FiO2(S/F) and PaO2/FiO2(P/F) so as to determine the possibility of ARDS severity identification based on noninvasive parameters. Methods The physiological parameters of corresponding patients were acquired from Medical Information Mart for Intensive Care (MIMIC-Ⅲ),and then divided into a training set and a test set randomly.In the training set the linear relationship between lg(S/F)and lg(P/F)was established with generalized linear regression model,and a log linear regression model was formed with the optimal regression equation;the linear relationship between lg(S/F)and lg(P/F)was compared with that between S/F and P/F.In the test set,the two models were compared on the identification of ARDS in case P/F values were 100(mild ARDS),200(moderate ARDS)and 300(severe ARDS)respectively.Results In the training set(n=61 634)the linear relationship between lg(S/F)and lg(P/F)was deduced as lg(S/F)=1.277+0.437×lg(P/F) (r=0.66,P<0.000 1),and the S/F thresholds in case P/F values were 100,200 and 300 respectively were 131,201 and 271.In the test set (n=26 758)the identification effect was verified with the acquired S/F thresholds,which proved better than that of traditional regression model.Conclusion Noninvasive parameter SpO2/FiO2can replace PaO2/FiO2for the auxiliary diagnosis of ARDS in case the result of blood gas analysis is absent.

Evaluation of multiple oxygenation indexes in acute respiratory distress syndrome / 军事医学

Acute respiratory distress syndrome(ARDS)and acute lung injury are grave syndromes associated with high morbidity of the mortality.Currently,the criteria for the classification of the severity of ARDS are the PaO 2/FiO2values, while OI,S/F and OSI values are also used as ancillary diagnostic and grading criteria for ARDS.In this review,we sum-marize the effects of four indicators on the diagnosis and severity of ARDS patients,their respective strengths and weaknes-ses,and predit the future development of the classification of severity of ARDS.