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Classifying multice...
Classifying multicenter approaches to invasive mechanical ventilation for infants with bronchopulmonary dysplasia using hierarchical clustering analysis
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- Kielt, Matthew (författare)
- 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.
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- Hatch, L. Dupree (författare)
- Vanderbilt Univ, Dept Pediat,Med Ctr, Mildred Stahlman Div Neonatol, Monroe Carrell Jr Childrens Hosp, Nashville, TN USA.
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- Levin, Jonathan C. (författare)
- Harvard Univ, Boston Childrens Hosp, Div Pulm & Newborn Med, Med Sch, Boston, MA USA.
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- Napolitano, Natalie (författare)
- Childrens Hosp Philadelphia, Dept Resp Care, Philadelphia, PA USA.
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- Abman, Steven H. (författare)
- Univ Colorado, Childrens Hosp Colorado, Pediat Heart Lung Ctr, Dept Pediat,Sch Med, Aurora, CO USA.
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Baker, Christopher D. (författare)
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- Eldredge, Laurie C. (författare)
- Univ Washington, Seattle Childrens Hosp, Dept Pediat,Sch Med, Div Pulm & Sleep Med, Seattle, WA USA.
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- Collaco, Joseph M. (författare)
- Johns Hopkins Univ, Eudowood Div Pediat Resp Sci, Sch Med, Baltimore, MD USA.
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- McGrath-Morrow, Sharon A. (författare)
- Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Div Pulm & Sleep Med, Philadelphia, PA USA.
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- Rose, Rebecca S. (författare)
- Indiana Univ Sch Med, Riley Childrens Hosp, Dept Pediat, Div Neonatol, Indianapolis, IN USA.
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- Lai, Khanh (författare)
- Univ Utah, Primary Childrens Hosp, Div Pediat Pulm & Sleep Med, Sch Med, Salt Lake City, UT USA.
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- Keszler, Martin (författare)
- Brown Univ, Warren Alpert Med Sch, Dept Pediat, Div Neonatol, Providence, RI USA.
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- Sindelar, Richard, Docent, 1964- (författare)
- Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning
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Nelin, Leif D. (författare)
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- McKinney, Robin L. (författare)
- Brown Univ, Warren Alpert Med Sch, Div Pediat Crit Care Med, Dept Pediat, Providence, RI USA.
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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)
- John Wiley & Sons, 2023
- 2023
- Engelska.
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Ingår i: Pediatric Pulmonology. - : John Wiley & Sons. - 8755-6863 .- 1099-0496. ; 58:8, s. 2323-2332
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- chronic lung disease
- neonatology
- pulmonology
- tracheostomy
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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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visa fler...
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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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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Pediatrik
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Lungmedicin och ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Anestesi och int ...
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Uppsala universitet