Validation of a novel Bayesian predictive algorithm for detection of carbon dioxide retention using retrospective neonatal ICU data.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-07-23 DOI:10.1038/s41372-025-02369-z

Luke T Viehl, Jeffrey L Segar, Zachary A Vesoulis

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引用次数: 0

Abstract

Objective: To validate a novel Bayesian prediction algorithm (IVCO2 index) to calculate the probability of CO₂ retention in neonates using existing medical device outputs.

Study design: A retrospective validation study from two level IV NICUs between September 2021 and May 2023. The algorithm calculated probabilities of PaCO₂ exceeding 50 mmHg (IVCO2_50) and 60 mmHg (IVCO2_60) using multimodal physiologic data. Performance was assessed through ROC analysis, range utilization, and resolution/limitation analysis.

Results: Among 180 included neonates, 1092 arterial blood gas measurements were analyzed. IVCO2_50 and IVCO2_60 demonstrated excellent discriminatory performance (AUC 0.87, 95% CI 0.85-0.89 and AUC 0.90, 95% CI 0.68-0.93, respectively). The risk of elevated PaCO₂ scaled linearly with increasing index quartiles. Minimum scores (<1) showed >6-fold reduction in hypercapnia risk, while maximum scores (>99) demonstrated >3-fold reduction in normocapnia risk.

Conclusion: The IVCO2 index accurately predicts CO₂ retention in neonates, offering potential for early detection of ventilation inadequacy without additional invasive monitoring.

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利用回顾性新生儿ICU数据验证一种新的贝叶斯预测算法用于检测二氧化碳潴留。

目的：验证一种新的贝叶斯预测算法（IVCO2指数），利用现有医疗器械输出计算新生儿CO2滞留概率。研究设计：在2021年9月至2023年5月期间对两个IV级nicu进行回顾性验证研究。该算法利用多模态生理数据计算PaCO2超过50 mmHg （IVCO2_50）和60 mmHg （IVCO2_60）的概率。通过ROC分析、范围利用率和分辨率/限制分析来评估性能。结果：在180例纳入的新生儿中，分析了1092例动脉血气测量。IVCO2_50和IVCO2_60表现出优异的区分性能（AUC分别为0.87,95% CI 0.85-0.89和0.90,95% CI 0.68-0.93）。PaCO2升高的风险随着指数四分位数的增加呈线性增长。最低评分（高碳酸血症风险降低6倍），而最高评分（bbb99）显示正常碳酸血症风险降低>3倍。结论：IVCO2指数能准确预测新生儿的CO2潴留，为早期发现通气不足提供了可能，无需额外的有创监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.