在婴儿和新生儿中使用视频喉镜进行气管插管的人工智能辅助系统的开发

IF 5.1 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-06-25 DOI:10.1016/j.jclinane.2025.111914

Hiroki Nakamura MD , Kouki Fukuda MD , Takahiko Asano MD , Tatsuhiko Masue MD, PhD

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引用次数: 0

摘要

背景：婴儿和新生儿的喉部有时难以用视频喉镜识别。本研究旨在开发一种人工智能（AI）辅助模型，该模型可以根据视频喉镜获得的图像识别喉部，包括开放的声带和杓状部分。方法首先，作者从653个视频中提取了1197张图像作为训练和验证数据。使用YOLOv8n开发了人工智能辅助喉部识别模型。然后，每150帧从另外的63个视频中选择399个图像作为测试数据。结果人工智能辅助喉部识别模型的灵敏度为0.74，特异度为0.99，曲线下面积为0.91。在没有障碍的情况下，人工智能模型正确地识别了开口声带和杓状体部分。观察食道喉部误认及因障碍导致喉部未被发现的病例。结论人工智能辅助模型能有效识别视频喉镜检查时的喉部，包括开口声带和杓状部分，有可能提高婴幼儿气管插管的安全性。然而，食道误诊仍然是关键。需要进一步的研究来完善模型并确保其在临床实践中的可靠性。

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Development of an artificial intelligence-assisted system for tracheal intubation using a video laryngoscope in infants and neonates

Background

The larynx of infants and neonates is occasionally challenging to identify using video laryngoscope. This study aimed to develop an artificial intelligence (AI)-assisted model that can identify the larynx, including the opening vocal cord and the arytenoid portion, on images obtained using a video laryngoscope.

Methods

First, 1197 images were extracted by the author from the 653 videos for train and validation data. An AI-assisted model for identifying the larynx was developed using YOLOv8n. Then, 399 images were selected from the additional 63 videos for the test data at every 150 frames.

Results

The sensitivity, specificity, and area under the curve of the AI-assisted model for identifying the larynx were 0.74, 0.99, and 0.91, respectively. The AI model correctly identified the opening vocal cord and arytenoid portion in cases without obstacles. Esophageal misidentification of the larynx and undetected cases of the larynx caused by obstacles were observed.

Conclusions

The AI-assisted model effectively identified the larynx, including the opening vocal cord and the arytenoid portion, during video laryngoscopy and potentially can enhance the safety of tracheal intubation of infants and neonates. However, esophageal misidentification remains critical. Further studies are needed to refine the model and ensure its reliability in clinical practice.

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.