回到未来:数字听诊新技术在危重病人 Covid-19 前瞻性观察研究中的应用。

IF 8.5 Q1 RESPIRATORY SYSTEM
Evangelos Kaimakamis, Serafeim Kotoulas, Myrto Tzimou, Christos Karachristos, Chrysavgi Giannaki, Vassileios Kilintzis, Leandros Stefanopoulos, Evangelos Chatzis, Nikolaos Beredimas, Bruno Rocha, Diogo Pessoa, Rui Pedro Paiva, Nicos Maglaveras, Militsa Bitzani
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引用次数: 0

摘要

背景:Covid-19 大流行给重症监护病房(ICU)造成了巨大压力。对于因 Covid-19 而导致严重 ARDS 的患者,呼吸力学对于确定肺损伤的严重程度非常重要。尽管肺部听诊有其优点,但在大流行期间却无法使用。本研究的主要目的是调查严重 Covid-19 ARDS 成人患者的肺部听诊声音特征与肺部机械特性、住院时间(LOS)和存活率之间的关系:方法:纳入 2020 年至 2021 年期间入住大型重症监护病房的连续患者(n = 173)。数字听诊器获取听诊音,并将其存储到在线数据库中,以便重放和使用先进的人工智能技术进一步处理。相关性和回归分析探讨了数字听诊结果与肺力学或重症监护室结果之间的关系。由此产生的肺部声音注释数据库也作为补充材料公开发布:结果:"唧唧 "声的存在与重症监护室的住院时间、预后和 90 天死亡率有关。其他特征(年龄、入院时的 SOFA 评分和氧合指数、最小噼啪熵)对结果有显著影响。影响 90 天存活率的其他特征还有年龄和平均噼啪熵。多变量逻辑回归显示,年龄、基线SOFA、基线氧合指数和最小噼啪熵对存活率有影响:结论:呼吸力学与各种杂音有关,而肺部声音分析和某些杂音的存在与重症监护室的结果和 90 天存活率相关。噼啪声的频谱特征可作为生存率的预后因素,突出了数字听诊的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Back to the future: the novel art of digital auscultation applied in a prospective observational study of critically ill Covid-19 patients.

Background: The Covid-19 pandemic has caused immense pressure on Intensive Care Units (ICU). In patients with severe ARDS due to Covid-19, respiratory mechanics are important for determining the severity of lung damage. Lung auscultation could not be used during the pandemic despite its merit. The main objective of this study was to investigate associations between lung auscultatory sound features and lung mechanical properties, length of stay (LOS) and survival, in adults with severe Covid-19 ARDS.

Methods: Consecutive patients admitted to a large ICU between 2020 and 2021 (n = 173) were included. Digital stethoscopes obtained auscultatory sounds and stored them in an on-line database for replay and further processing using advanced AI techniques. Correlation and regression analysis explored relationships between digital auscultation findings and lung mechanics or the ICU outcome. The resulting annotated lung sounds database is also publicly available as supplementary material.

Results: The presence of squawks was associated with the ICU LOS, outcome and 90-day mortality. Other features (age, SOFA score & oxygenation index upon admission, minimum crackle entropy) had significant impact on outcome. Additional features affecting the 90-d survival were age and mean crackle entropy. Multivariate logistic regression showed that survival was affected by age, baseline SOFA, baseline oxygenation index and minimum crackle entropy.

Conclusions: Respiratory mechanics were associated with various adventitious sounds, whereas the lung sound analytics and the presence of certain adventitious sounds correlated with the ICU outcome and the 90-d survival. Spectral features of crackles sounds can serve as prognostic factors for survival, highlighting the importance of digital auscultation.

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来源期刊
Pneumonia
Pneumonia RESPIRATORY SYSTEM-
自引率
1.50%
发文量
7
审稿时长
11 weeks
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