TY - JOUR
T1 - Toward Evaluating Critical Factors of Extubation Outcome with XCSR-Generated Rules
AU - Huang, Po Hsun
AU - Chen, Lian Yu
AU - Chung, Wei Chan
AU - Sheu, Chau Chyun
AU - Hsiao, Tzu Chien
AU - Tsai, Jong Rung
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2022/11
Y1 - 2022/11
N2 - Predicting the correct timing for extubation is pivotal for critically ill patients with mechanical ventilation support. Evidence suggests that extubation failure occurs in approximately 15–20% of patients, despite their passing of the extubation evaluation, necessitating reintubation. For critically ill patients, reintubation invariably increases mortality risk and medical costs. The numerous parameters that have been proposed for extubation decision-making, which constitute the key predictors of successful extubation, remains unclear. In this study, an extended classifier system capable of processing real-value inputs was proposed to select features of successful extubation. In total, 40 features linked to clinical information and variables acquired during spontaneous breathing trial (SBT) were used as the environmental inputs. According to the number of “don’t care” rules in a population set, Probusage, the probability of the feature not being classified as above rules, can be calculated. A total of 228 subjects’ results showed that Probusage was higher than 90% for minute ventilation at the 1st, 30th, 60th, and 90th minutes; respiratory rate at the 90th minute; and body weight, indicating that the variance in respiratory parameters during an SBT are critical predictors of successful extubation. The present XCSR model is useful to evaluate critical factors of extubation outcomes. Additionally, the current findings suggest that SBT duration should exceed 90 min, and that clinicians should consider the variance in respiratory variables during an SBT before making extubation decisions.
AB - Predicting the correct timing for extubation is pivotal for critically ill patients with mechanical ventilation support. Evidence suggests that extubation failure occurs in approximately 15–20% of patients, despite their passing of the extubation evaluation, necessitating reintubation. For critically ill patients, reintubation invariably increases mortality risk and medical costs. The numerous parameters that have been proposed for extubation decision-making, which constitute the key predictors of successful extubation, remains unclear. In this study, an extended classifier system capable of processing real-value inputs was proposed to select features of successful extubation. In total, 40 features linked to clinical information and variables acquired during spontaneous breathing trial (SBT) were used as the environmental inputs. According to the number of “don’t care” rules in a population set, Probusage, the probability of the feature not being classified as above rules, can be calculated. A total of 228 subjects’ results showed that Probusage was higher than 90% for minute ventilation at the 1st, 30th, 60th, and 90th minutes; respiratory rate at the 90th minute; and body weight, indicating that the variance in respiratory parameters during an SBT are critical predictors of successful extubation. The present XCSR model is useful to evaluate critical factors of extubation outcomes. Additionally, the current findings suggest that SBT duration should exceed 90 min, and that clinicians should consider the variance in respiratory variables during an SBT before making extubation decisions.
KW - extended classifier system
KW - mechanical ventilation
KW - spontaneous breathing trial
KW - successful extubation
UR - http://www.scopus.com/inward/record.url?scp=85146679627&partnerID=8YFLogxK
U2 - 10.3390/bioengineering9110701
DO - 10.3390/bioengineering9110701
M3 - Article
AN - SCOPUS:85146679627
SN - 2306-5354
VL - 9
JO - Bioengineering
JF - Bioengineering
IS - 11
M1 - 701
ER -