Using real-time visualization system for data-driven decision support to achieve lung protective strategy: a retrospective observational study.

BACKGROUND: Although lung protective strategy and adjunctive intervention are associated with improved survival in patients with acute respiratory distress syndrome (ARDS), the implementation of effective therapies remains low. This study aimed to evaluate whether the use of business intelligence (BI) for real-time data visualization is associated with an improvement in lung protective strategy and adjunctive therapy. METHODS: A retrospective observational cohort study was conducted on patients with ARDS admitted between September 2020 and June 2021 at two intensive care units (ICUs) of a tertiary referral hospital in Taiwan. BI was imported for data visualization and integration to assist in clinical decision in one of the ICUs. The primary outcomes were the implementation of low tidal volume ventilation (defined as tidal volume/predicted body weight ≤ 8 mL/kg) within 24 h from ARDS onset. The secondary outcomes included ICU and hospital mortality rates. RESULTS: Among the 1201 patients admitted to the ICUs during the study period, 148 (12.3%) fulfilled the ARDS criteria, with 86 patients in the BI-assisted group and 62 patients in the standard-of-care (SOC) group. Disease severity was similar between the two groups. The application of low tidal volume ventilation strategy was significantly improved in the BI-assisted group compared with that in the SOC group (79.1% vs. 61.3%, p = 0.018). Despite their ARDS and disease severity, the BI-assisted group tended to achieve low tidal volume ventilation. The ICU and hospital mortality were lower in the BI-assisted group. CONCLUSIONS: The use of real-time visualization system for data-driven decision support was associated with significantly improved compliance to low tidal volume ventilation strategy, which enhanced the outcomes of patients with ARDS in the ICU.

Association of Polymorphisms in DNA Repair Gene XRCC3 with Asthma in Taiwan.

AIM: Accumulating evidence suggests that DNA damage and repair play a role in asthma etiology, however, little is known about the contribution of genotypes of DNA repair genes to asthma susceptibility. This study aimed to examine the contribution of genotypes of DNA double-strand break repair gene X-ray repair cross complementing protein 3 (XRCC3) and its polymorphisms to asthma risk in the Taiwanese. MATERIALS AND METHODS: Associations of seven XRCC3 genotypes, namely rs1799794, rs45603942, rs861530, rs3212057, rs1799796, rs861539 and rs28903081, with the risk of asthma were investigated among 198 patients with asthma and 453 non-asthma controls by polymerase chain reaction-restriction fragment length polymorphism genotyping methodology. RESULTS: Unlike Caucasian populations, no polymorphic genotypes at XRCC3 rs3212057 or rs28903081 were found among the Taiwanese. For the genotypes of XRCC3 rs1799794, rs45603942, rs861530, rs1799796 and rs861539, the percentages of hetero-and homo-variant genotypes were not differentially represented between the asthma patient and the non-asthma control groups. In addition, there was no differential distribution of allelic frequencies for these XRCC3 polymorphic sites between the two groups. No interaction of these genotypes with gender or age were found. CONCLUSION: Although XRCC3 plays a role in asthma etiology, the variant XRCC3 genotypes do not serve as practicable predictive markers for asthma risk in Taiwanese.

The Contribution of Interleukin-10 Promoter Genotypes to Susceptibility to Asthma in Adults.

AIM: Accumulating evidence suggests that inflammatory processes play a role in asthma etiology, and interleukin-10 (IL10) is an important immunosuppressive cytokine. The present study aimed to evaluate the contribution of IL10 promoter A-1082G (rs1800896), T-819C (rs3021097), A-592C (rs1800872) genetic polymorphisms to the risk of asthma in Taiwan. MATERIALS AND METHODS: Associations of three IL10 polymorphic genotypes with risk of asthma were investigated among 198 patients with asthma and 453 non-asthmatic healthy controls, by polymerase chain reaction-restriction fragment length polymorphism genotyping method. RESULTS: The results showed that the percentages of TT, TC and CC for IL-10 T-819C genotypes were differentially represented at 63.1%, 32.3% and 4.6%, respectively, in the patient group and 53.0%, 36.4% and 10.6%, respectively, in the healthy control group (p for trend=0.0114). The CC genotype carriers were at lower risk for asthma (odds ratio=0.36, 95% confidence interval=0.17-0.76, p=0.0055). There was no difference in the distribution of A-1082G or A-592C genotype between the asthma and non-asthma groups. The protective effects of the CC genotype were obvious among males, but not females, and those aged 25 up to 40 years but not those aged over 40 years. CONCLUSION: The CC genotype of IL10 T-819C compared to the TT genotype may have a protective effect on asthma risk in younger adults (25-40 years old), and males in Taiwan.