目的 :研究无创参数SpO_2/FiO_2(S/F)和PaO_2/FiO_2(P/F)之间的关系,探索使用无创参数辨识急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疾病严重程度的可能性。方法:访问重症医学信息数据库(Medical Information ...目的 :研究无创参数SpO_2/FiO_2(S/F)和PaO_2/FiO_2(P/F)之间的关系,探索使用无创参数辨识急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疾病严重程度的可能性。方法:访问重症医学信息数据库(Medical Information Mart for Intensive Care,MIMIC-Ⅲ),获取患者相关生理参数,将患者数据随机分为训练集和测试集。使用训练集,利用广义线性回归模型,建立lg(S/F)与lg(P/F)之间的线性关系,选择最优的回归方程作为对数线性回归模型,并将lg(S/F)与lg(P/F)之间的线性关系和S/F与P/F之间的线性关系进行对比研究。使用测试集,比较2种模型对于P/F在100(重度ARDS)、200(中度ARDS)、300(轻度ARDS)处的辨识效果。结果:在训练集(n=61 634)上推导出lg(P/F)与lg(S/F)之间的线性关系:lg(S/F)=1.277+0.437×lg(P/F)(r=0.66,P<0.000 1),并确定了P/F在100、200、300处对应的S/F阈值为131、201、271。在测试集(n=26 758)上使用S/F阈值验证了其辨识效果,且较传统线性回归模型辨识结果有了明显改善。结论:通过研究,认为在患者血气分析结果缺失的情况下,可以使用无创参数SpO_2/FiO_2代替PaO_2/FiO_2作为ARDS患者病情诊断的辅助手段。展开更多
Aims: Bathing in deep, Japanese-style bathtubs is associated with high rates of sudden death in the elderly in Japan. The predominant causes of death in such cases are cardiovascular events and drowning. Blood pressur...Aims: Bathing in deep, Japanese-style bathtubs is associated with high rates of sudden death in the elderly in Japan. The predominant causes of death in such cases are cardiovascular events and drowning. Blood pressure changes induced by water pressure and high temperature during bathing may be an important cause of these accidents. Therefore, we investigated the changes in blood pressure, heart rate, and oxygen saturation (SpO2) before and after bathing in elderly Japanese individuals. Methods: Forty-eight elderly (average age, 86.4 ± 7.5 years) persons were enrolled in this study. Results: Changes in systolic blood pressure after bathing correlated negatively with baseline blood pressure before bathing, and participants with baseline systolic blood pressures of <125 mmHg experienced a greater elevation in blood pressure while bathing. Pulse rate was significantly increased after bathing, and the change in pulse rate correlated negatively with the baseline values. SpO2 did not differ significantly during bathing, but changes in SpO2 correlated negatively with baseline values. Lean participants showed a more marked elevation of SpO2, and those with hypertension showed reduced SpO2. Conclusion: These data suggest that the disabled elderly with low blood pressure experience trends in cardiovascular response during bathing which differ from those of young persons.展开更多
文摘目的 :研究无创参数SpO_2/FiO_2(S/F)和PaO_2/FiO_2(P/F)之间的关系,探索使用无创参数辨识急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疾病严重程度的可能性。方法:访问重症医学信息数据库(Medical Information Mart for Intensive Care,MIMIC-Ⅲ),获取患者相关生理参数,将患者数据随机分为训练集和测试集。使用训练集,利用广义线性回归模型,建立lg(S/F)与lg(P/F)之间的线性关系,选择最优的回归方程作为对数线性回归模型,并将lg(S/F)与lg(P/F)之间的线性关系和S/F与P/F之间的线性关系进行对比研究。使用测试集,比较2种模型对于P/F在100(重度ARDS)、200(中度ARDS)、300(轻度ARDS)处的辨识效果。结果:在训练集(n=61 634)上推导出lg(P/F)与lg(S/F)之间的线性关系:lg(S/F)=1.277+0.437×lg(P/F)(r=0.66,P<0.000 1),并确定了P/F在100、200、300处对应的S/F阈值为131、201、271。在测试集(n=26 758)上使用S/F阈值验证了其辨识效果,且较传统线性回归模型辨识结果有了明显改善。结论:通过研究,认为在患者血气分析结果缺失的情况下,可以使用无创参数SpO_2/FiO_2代替PaO_2/FiO_2作为ARDS患者病情诊断的辅助手段。
文摘Aims: Bathing in deep, Japanese-style bathtubs is associated with high rates of sudden death in the elderly in Japan. The predominant causes of death in such cases are cardiovascular events and drowning. Blood pressure changes induced by water pressure and high temperature during bathing may be an important cause of these accidents. Therefore, we investigated the changes in blood pressure, heart rate, and oxygen saturation (SpO2) before and after bathing in elderly Japanese individuals. Methods: Forty-eight elderly (average age, 86.4 ± 7.5 years) persons were enrolled in this study. Results: Changes in systolic blood pressure after bathing correlated negatively with baseline blood pressure before bathing, and participants with baseline systolic blood pressures of <125 mmHg experienced a greater elevation in blood pressure while bathing. Pulse rate was significantly increased after bathing, and the change in pulse rate correlated negatively with the baseline values. SpO2 did not differ significantly during bathing, but changes in SpO2 correlated negatively with baseline values. Lean participants showed a more marked elevation of SpO2, and those with hypertension showed reduced SpO2. Conclusion: These data suggest that the disabled elderly with low blood pressure experience trends in cardiovascular response during bathing which differ from those of young persons.
