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Classifying multice...
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Kielt, MatthewOhio State Univ, Nationwide Childrens Hosp, Dept Pediat, Div Neonatol,Coll Med, Columbus, OH USA.;Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat,Coll Med, Div Neonatol, 700 Childrens Dr, Columbus, OH 43205 USA.
(författare)
Classifying multicenter approaches to invasive mechanical ventilation for infants with bronchopulmonary dysplasia using hierarchical clustering analysis
- Artikel/kapitelEngelska2023
Förlag, utgivningsår, omfång ...
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John Wiley & Sons,2023
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LIBRIS-ID:oai:DiVA.org:uu-512805
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-512805URI
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https://doi.org/10.1002/ppul.26488DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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IntroductionEvidence-based ventilation strategies for infants with severe bronchopulmonary dysplasia (BPD) remain unknown. Determining whether contemporary ventilation approaches cluster as specific BPD strategies may better characterize care and enhance the design of clinical trials. The objective of this study was to test the hypothesis that unsupervised, multifactorial clustering analysis of point prevalence ventilator setting data would classify a discrete number of physiology-based approaches to mechanical ventilation in a multicenter cohort of infants with severe BPD.MethodsWe performed a secondary analysis of a multicenter point prevalence study of infants with severe BPD treated with invasive mechanical ventilation. We clustered the cohort by mean airway pressure (MAP), positive end expiratory pressure (PEEP), set respiratory rate, and inspiratory time (Ti) using Ward's hierarchical clustering analysis (HCA).ResultsSeventy-eight patients with severe BPD were included from 14 centers. HCA classified three discrete clusters as determined by an agglomerative coefficient of 0.97. Cluster stability was relatively strong as determined by Jaccard coefficient means of 0.79, 0.85, and 0.77 for clusters 1, 2, and 3, respectively. The median PEEP, MAP, rate, Ti, and PIP differed significantly between clusters for each comparison by Kruskall–Wallis testing (p < 0.0001).ConclusionsIn this study, unsupervised clustering analysis of ventilator setting data identified three discrete approaches to mechanical ventilation in a multicenter cohort of infants with severe BPD. Prospective trials are needed to determine whether these approaches to mechanical ventilation are associated with specific severe BPD clinical phenotypes and differentially modify respiratory outcomes.
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Hatch, L. DupreeVanderbilt Univ, Dept Pediat,Med Ctr, Mildred Stahlman Div Neonatol, Monroe Carrell Jr Childrens Hosp, Nashville, TN USA.
(författare)
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Levin, Jonathan C.Harvard Univ, Boston Childrens Hosp, Div Pulm & Newborn Med, Med Sch, Boston, MA USA.
(författare)
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Napolitano, NatalieChildrens Hosp Philadelphia, Dept Resp Care, Philadelphia, PA USA.
(författare)
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Abman, Steven H.Univ Colorado, Childrens Hosp Colorado, Pediat Heart Lung Ctr, Dept Pediat,Sch Med, Aurora, CO USA.
(författare)
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Baker, Christopher D.
(författare)
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Eldredge, Laurie C.Univ Washington, Seattle Childrens Hosp, Dept Pediat,Sch Med, Div Pulm & Sleep Med, Seattle, WA USA.
(författare)
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Collaco, Joseph M.Johns Hopkins Univ, Eudowood Div Pediat Resp Sci, Sch Med, Baltimore, MD USA.
(författare)
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McGrath-Morrow, Sharon A.Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Div Pulm & Sleep Med, Philadelphia, PA USA.
(författare)
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Rose, Rebecca S.Indiana Univ Sch Med, Riley Childrens Hosp, Dept Pediat, Div Neonatol, Indianapolis, IN USA.
(författare)
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Lai, KhanhUniv Utah, Primary Childrens Hosp, Div Pediat Pulm & Sleep Med, Sch Med, Salt Lake City, UT USA.
(författare)
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Keszler, MartinBrown Univ, Warren Alpert Med Sch, Dept Pediat, Div Neonatol, Providence, RI USA.
(författare)
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Sindelar, Richard,Docent,1964-Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning(Swepub:uu)richsind
(författare)
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Nelin, Leif D.
(författare)
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McKinney, Robin L.Brown Univ, Warren Alpert Med Sch, Div Pediat Crit Care Med, Dept Pediat, Providence, RI USA.
(författare)
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Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat, Div Neonatol,Coll Med, Columbus, OH USA.;Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat,Coll Med, Div Neonatol, 700 Childrens Dr, Columbus, OH 43205 USA.Vanderbilt Univ, Dept Pediat,Med Ctr, Mildred Stahlman Div Neonatol, Monroe Carrell Jr Childrens Hosp, Nashville, TN USA.
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Pediatric Pulmonology: John Wiley & Sons58:8, s. 2323-23328755-68631099-0496
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Kielt, Matthew
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Hatch, L. Dupree
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Levin, Jonathan ...
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Napolitano, Nata ...
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Abman, Steven H.
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Baker, Christoph ...
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Eldredge, Laurie ...
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Collaco, Joseph ...
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McGrath-Morrow, ...
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Rose, Rebecca S.
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Lai, Khanh
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Keszler, Martin
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Sindelar, Richar ...
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Nelin, Leif D.
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McKinney, Robin ...
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