Acute Kidney Injury Prediction Model Using Cystatin-C, Beta-2 Microglobulin, and Neutrophil Gelatinase-Associated Lipocalin Biomarker in Sepsis Patients.

Introduction: AKI is a frequent complication in sepsis patients and is estimated to occur in almost half of patients with severe sepsis. However, there is currently no effective therapy for AKI in sepsis. Therefore, the therapeutic approach is focused on prevention. Based on this, there is an opportunity to examine a panel of biomarker models for predicting AKI. Material and Methods: This prospective cohort study analysed the differences in Cystatin C, Beta-2 Microglobulin, and NGAL levels in sepsis patients with AKI and sepsis patients without AKI. The biomarker modelling of AKI prediction was done using machine learning, namely Orange Data Mining. In this study, 130 samples were analysed by machine learning. The parameters used to obtain the biomarker panel were 23 laboratory examination parameters. Results: This study used SVM and the Naïve Bayes model of machine learning. The SVM model's sensitivity, specificity, NPV, and PPV were 50%, 94.4%, 71.4%, and 87.5%, respectively. For the Naïve Bayes model, the sensitivity, specificity, NPV, and PPV were 83.3%, 77.8%, 87.5%, and 71.4%, respectively. Discussion: This study's SVM machine learning model has higher AUC and specificity but lower sensitivity. The Naïve Bayes model had better sensitivity; it can be used to predict AKI in sepsis patients. Conclusion: The Naïve Bayes machine learning model in this study is useful for predicting AKI in sepsis patients.

Serratus anterior plane block as a successful single anesthesia technique for thoracoscopy biopsy surgery: A case series.

Thoracic surgery is one of the most common surgeries that causes severe postoperative pain. Inadequate pain management results in longer hospital stays and recovery periods, as well as psychological changes, quality of life, and patient satisfaction. Ultrasound-guided serratus anterior plane block (SAPB) is a promising interfascial plane block that may provide adequate analgesia. We report three cases of suspected lung cancer patients who underwent thoracoscopic biopsy and postoperative chest drainage. The patients underwent SAPB with light sedation during the procedure. After surgery, the patients were observed in the intensive care unit. For postoperative pain management, nonsteroidal anti-inflammatory drugs (NSAIDs) were used as an adjunct to intraoperative SAPB. Adequate pain control was achieved on a numeric rating scale of 0 to 2 over the 1 × 24 postoperative period, and opioid analgesics were not used in these patients. SAPB was successfully used in patients undergoing thoracoscopy biopsy surgery, with excellent outcomes in pain control after the surgery, reduction in perioperative opioid administration, and decreased postoperative pulmonary complications.