Another Question Answered « AVERT-IT

All the clinicians involved in our project are specialists in neurosurgery. Hypotensive events are a key issue for them, because of the damage caused to the brain.

But a major question for us has been will our research result in a technology which could apply in general intensive care. Specialist neurosurgery units account for only a small proportion of the total ICU beds. We’ll find it much easier to justify a commercial operation if all ICU beds are potential installations.

Great News – Physionet based at MIT and funded by the National Institutes of Health’s NIBIB and NIGMS, recently announced its “challenge” for 2009 – Predicting Acute Hypotensive Episodes.

As a basis for the challenge Physionet provides a data set collected during intensive care of cardiology patients. The challenge itself isn’t appropriate for our research – we’re targeting a different definition of episode -but the instructions for the challenge provides an interesting perspective. Here’s and extract.

“Among the most critical events that occur in intensive care units (ICUs), acute hypotensive episodes require effective, prompt intervention. Left untreated, such episodes may result in irreversible organ damage and death. Timely and appropriate interventions can reduce these risks. Determining what intervention is appropriate in any given case depends on diagnosing the cause of the episode, which might be sepsis, myocardial infarction, cardiac arrhythmia, pulmonary embolism, hemorrhage, dehydration, anaphylaxis, effects of medication, or any of a wide variety of other causes of hypovolemia, insufficient cardiac output, or vasodilatory shock. Often the best choice may be a suboptimal but relatively safe intervention, simply to buy enough time to select a more effective treatment without exposing the patient to the additional risks of delaying treatment.

Of the 2320 patients whose monitored waveforms and accompanying clinical data were included in the MIMIC II Database as of December 2008, arterial blood pressure was recorded in 1237 (53%); among these 1237 patients, 511 (41%) experienced recorded episodes of acute hypotension (as defined below) during their ICU stays. The mortality rate for these 511 patients is more than twice that of the MIMIC II population as a whole. To the extent that one might forecast acute hypotensive episodes in the ICU, there is a possibility of improving care and survival of patients at risk of these events. “

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One Response to Another Question Answered « AVERT-IT

  1. Pingback: Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease | Cardiovascular Disease

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