Mortality Prediction in Cardiac Intensive Care Unit Patients: A Systematic Review of Existing and Artificial Intelligence Augmented Approaches

Rafie, Nikita; Jentzer, Jacob C.; Noseworthy, Peter A.; Kashou, Anthony H.

doi:10.3389/frai.2022.876007

Cited by 5 publications

(4 citation statements)

References 42 publications

(80 reference statements)

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“…The complexity as well as the severity of the patients admitted in CICUs makes this population quite special and requires personalized management based on several parameters mainly clinical, electrocardiographic, biological, and echocardiographic, in order to stratify the severity of these patients to predict the prognosis. With the evolution of artificial intelligence, it has been shown that several automated and dynamically evaluated algorithms can predict the evolution during hospitalization in CICU in a pertinent way (72).…”

Section: Artificial Intelligence (Ai) In Cicusmentioning

confidence: 99%

Cardiac intensive care unit: where we are in 2023

Bouchlarhem,

Bazid,

Ismaili

et al. 2023

Front. Cardiovasc. Med.

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Cardiac intensive care has been a constantly evolving area of research and innovation since the beginning of the 21st century. The story began in 1961 with Desmond Julian's pioneering creation of a coronary intensive care unit to improve the prognosis of patients with myocardial infarction, considered the major cause of death in the world. These units have continued to progress over time, with the introduction of new therapeutic means such as fibrinolysis, invasive hemodynamic monitoring using the Swan-Ganz catheter, and mechanical circulatory assistance, with significant advances in percutaneous interventional coronary and structural procedures. Since acute cardiovascular disease is not limited to the management of acute coronary syndromes and includes other emergencies such as severe arrhythmias, acute heart failure, cardiogenic shock, high-risk pulmonary embolism, severe conduction disorders, and post-implantation monitoring of percutaneous valves, as well as other non-cardiac emergencies, such as septic shock, severe respiratory failure, severe renal failure and the management of cardiac arrest after resuscitation, the conversion of coronary intensive care units into cardiac intensive care units represented an important priority. Today, the cardiac intensive care units (CICU) concept is widely adopted by most healthcare systems, whatever the country's level of development. The main aim of these units remains to improve the overall morbidity and mortality of acute cardiovascular diseases, but also to manage other non-cardiac disorders, such as sepsis and respiratory failure. This diversity of tasks and responsibilities has enabled us to classify these CICUs according to several levels, depending on a variety of parameters, principally the level of care delivered, the staff assigned, the equipment and technologies available, the type of research projects carried out, and the type of connections and networking developed. The European Society of Cardiology (ESC) and the American College of Cardiology (ACC) have detailed this organization in guidelines published initially in 2005 and updated in 2018, with the aim of harmonizing the structure, organization, and care offered by the various CICUs. In this state-of-the-art report, we review the history of the CICUs from the creation of the very first unit in 1968 to the discussion of their current perspectives, with the main objective of knowing what the CICUs will have become by 2023.

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Section: Artificial Intelligence (Ai) In Cicusmentioning

confidence: 99%

Cardiac intensive care unit: where we are in 2023

Bouchlarhem,

Bazid,

Ismaili

et al. 2023

Front. Cardiovasc. Med.

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“…AI has been widely applied in various fields, including sepsis detection and mortality prediction in ICUs. [13][14][15] However, most previous studies in this area have relied on retrospective medical record review. [16][17][18] It is important to note that there are poor correlations between non-real-time features and weaning outcomes at the time of extubation.…”

Section: Ai and Improvement In Healthcarementioning

confidence: 99%

The intervention of artificial intelligence to improve the weaning outcomes of patients with mechanical ventilation: Practical applications in the medical intensive care unit and the COVID-19 intensive care unit: A retrospective study

Lin,

Chang,

Liu

et al. 2024

Medicine

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Patients admitted to intensive care units (ICU) and receiving mechanical ventilation (MV) may experience ventilator-associated adverse events and have prolonged ICU length of stay (LOS). We conducted a survey on adult patients in the medical ICU requiring MV. Utilizing big data and artificial intelligence (AI)/machine learning, we developed a predictive model to determine the optimal timing for weaning success, defined as no reintubation within 48 hours. An interdisciplinary team integrated AI into our MV weaning protocol. The study was divided into 2 parts. The first part compared outcomes before AI (May 1 to Nov 30, 2019) and after AI (May 1 to Nov 30, 2020) implementation in the medical ICU. The second part took place during the COVID-19 pandemic, where patients were divided into control (without AI assistance) and intervention (with AI assistance) groups from Aug 1, 2022, to Apr 30, 2023, and we compared their short-term outcomes. In the first part of the study, the intervention group (with AI, n = 1107) showed a shorter mean MV time (144.3 hours vs 158.7 hours, P = .077), ICU LOS (8.3 days vs 8.8 days, P = .194), and hospital LOS (22.2 days vs 25.7 days, P = .001) compared to the pre-intervention group (without AI, n = 1298). In the second part of the study, the intervention group (with AI, n = 88) exhibited a shorter mean MV time (244.2 hours vs 426.0 hours, P = .011), ICU LOS (11.0 days vs 18.7 days, P = .001), and hospital LOS (23.5 days vs 40.4 days, P < .001) compared to the control group (without AI, n = 43). The integration of AI into the weaning protocol led to improvements in the quality and outcomes of MV patients.

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“…AI will enable us to (1) differentiate congestive heart failure from other causes of lung disease and to quantify the amount of pulmonary edema secondary to it, using process imaging data; (2) identify left ventricular systolic dysfunction using AI-electrocardiogram and reduce mortality in CICU patients and (3) identify disease phenotypes or endotypes, which can inform personalized management and clinical trials. 44,45 These AI-research driven advances, in addition to many others, herald a new age of patient care in the ICUs.…”

Section: Brave New World Of Cardiac Icusmentioning

confidence: 99%

Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort

Dhala¹,

Fusaro²,

Uddin³

et al. 2023

Methodist DeBakey Cardiovascular Journal

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A long-standing shortage of critical care intensivists and nurses, exacerbated by the coronavirus disease (COVID-19) pandemic, has led to an accelerated adoption of telecritical care in the United States (US). Due to their complex and high-acuity nature, cardiac, cardiovascular, and cardiothoracic intensive care units (ICUs) have generally been limited in their ability to leverage tele-critical care resources. In early 2020, Houston Methodist Hospital (HMH) launched its tele-critical care program called Virtual ICU, or vICU, to improve its ICU staffing efficiency while providing high-quality, continuous access to inperson and virtual intensivists and critical care nurses. This article provides a roadmap with prescriptive specifications for planning, launching, and integrating vICU services within cardiac and cardiovascular ICUs-one of the first such integrations among the leading academic US hospitals. The success of integrating vICU depends upon the (1) recruitment of intensivists and RNs with expertise in managing cardiac and cardiovascular patients on the vICU staff as well as concerted efforts to promote mutual trust and confidence between in-person and virtual providers, (2) consultations with the bedside clinicians to secure their buy-in on the merits of vICU resources, and (3) collaborative approaches to improve workflow protocols and communications. Integration of vICU has resulted in the reduction of monthly night-call requirements for the in-person intensivists and an increase in work satisfaction. Data also show that support of the vICU is associated with a significant reduction in the rate of Code Blue events (denoting a situation where a patient requires immediate resuscitation, typically due to a cardiac or respiratory arrest). As the providers become more comfortable with the advances in artificial intelligence and big data-driven technology, the Cardiac ICU Cohort continues to improve methods to predict and track patient trends in the ICUs. PATIENT POPULATION DESCRIPTION Medicine, general surgery and neurology patientsRespiratory failure secondary to pneumonia, status post complex abdominal surgery, cerebrovascular accident status post intervention. Preoperative cardiovascular, cardiac and vascular surgery patientsUnstable patients being evaluated for aortic dissection repair or cardiac surgery with or without devices. Heart transplant patient on inotropes or with intra-aortic balloon pump (IABP) or Impella. Cardiovascular and thoracic surgery patientsCoronary artery bypass, valve repair or replacement, cardiac tumor resection, pneumonectomy, lobectomy, esophagectomy, aortoesophageal repair. Complicated and combined vascular surgery patientsPost left ventricular assist device, heart transplant patients, aortic dissection repair (endovascular or open), superior vena cava syndrome repair, heart and/or lung transplant or combined with liver or kidney transplant. Congestive heart failure patientsAcute decompensated heart failure, including those with or without cardiac devices; any patient requiring i...

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Mortality Prediction in Cardiac Intensive Care Unit Patients: A Systematic Review of Existing and Artificial Intelligence Augmented Approaches

Cited by 5 publications

References 42 publications

Cardiac intensive care unit: where we are in 2023

Cardiac intensive care unit: where we are in 2023

The intervention of artificial intelligence to improve the weaning outcomes of patients with mechanical ventilation: Practical applications in the medical intensive care unit and the COVID-19 intensive care unit: A retrospective study

Integrating a Virtual ICU with Cardiac and Cardiovascular ICUs: Managing the Needs of a Complex and High-Acuity Specialty ICU Cohort

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