Patient-ventilator asynchrony (PVA) is prevalent in mechanical ventilation (MV) for critically ill patients and has been associated with adverse patient outcomes. However, studies investigating the associations between PVA and patient outcomes employ differing time windows for PVA evaluation. In this study, machine learning methods are used to quantify the prevalence and magnitude of asynchrony at different time windows, as well as its temporal trends. The study aims to identify the optimal time window for assessing the temporal changes in the asynchrony index (AI) and magnitude of asynchrony (Masyn,avg). This study uses Convolutional Neural Networks (CNN) and Convolutional Autoencoders (CAE) to detect incidences of PVA and quantify its severity in 30 MV respiratory failure patients with 2,722 h of respiratory data. The frequency of PVA and the breath-average magnitude were determined over different time periods, t, where t=0.5, 1, 2, 3, 4, 5, 10, 15, 20, 25, 30, 45, 60 min and throughout MV. The AI for the patients was determined using the CNN model. Given an asynchronous breath, the CAEs were used to reconstruct asynchrony-free waveforms. The Masyn,avg was quantified as the difference between the two waveforms. The change in AI (ΔAI) and the change in Masyn,avg (ΔMasyn,avg) for all time windows, t were also calculated for each patient. The median [interquartile range] overall AI and Masyn,avg for the patient cohort are 24.8 [12.9–46.1]% and 37.2 [33.4–45.3]% respectively. Analysis of the patient cohort also shows significant intra-patient variability in AI and Masyn,avg, while the inter-patient variation in AI is greater as compared to Masyn,avg. The cohort mean ΔAI and ΔMasyn,avg exhibit a converging trend with a minima at t=5 min and with values of 5.32 ± 2.37% and 2.80 ± 1.03%, respectively. A time window of t=5 min was preferred for AI and Masyn,avg evaluation as it can capture the granular changes in asynchrony while also being representative of longer temporal trends, thus preventing excessive variations in patient AI and Masyn,avg. Overall, this study provides new insight into both the short- and long-term trends of PVA in MV patients. By understanding these patterns, healthcare providers can enhance the monitoring of MV, leading to more informed and timely intervention. Ultimately, this could lead to improved patient care and outcomes. 

Exploring variable observational time windows for patient-ventilator asynchrony during mechanical ventilation treatment

Dehydration remains a critical issue in children and can pose a risk of mortality. Nurses play a crucial role in promptly and accurately preventing dehydration, beginning with the recognition of its causes and symptoms in patients. A thorough assessment by nurses is key to ensuring proper and timely treatment of dehydrated patients, especially in high-activity emergency units. The integration of technology into emergency units is essential for enhancing patient services and decision-making processes. This study aims to conduct a systematic review by analyzing the use of mobile phone applications in assessing signs of dehydration and possible management in hospital services. Four databases (Scopus, Science Direct, and Pubmed) were used in this study using the keywords assessment, smartphone, and dehydration management. Access to the quality of this study using a cross-sectional design from Joanna Briggs Institute. Use the PRISMA flowchart to summarize the study selection. Limit for the last eight years, namely 2017 – 2022. The results of this study met the inclusion criteria, including patients with dehydration caused by gastroenteritis problems and pediatric or pediatric patients. inclusion and exclusion criteria applied to the PICOS framework. 
The result of eleven studies in the article found that a digital-based dehydration management approach is very beneficial for the effectiveness of services and initial assessment of the patient's clinical condition. The integrity of digital technology in healthcare has revolutionized many aspects of healthcare management and delivery. By implementing digital solutions such as dehydration management documents, health workers can improve their ability to prevent and treat dehydration.

Assessment and Management of Dehydration in Children Based on Digital: A Systematic Review

Aims and objectives This study sets out to describe benefits from the implementation of electronic observation charting in intensive care units (ICU). This was an extension to the existing hospital wide digital health system. We evaluated error reduction, time-savings and the costs associated with conversion from paper to digital records. The world health emergency of COVID-19 placed extraordinary strain on ICU and staff opinion was evaluated to test how well the electronic system performed. Methods A clinically led project group working directly with programmers developed an electronic patient record for intensive care. Data error rates, time to add data and to make calculations were studied before and after the introduction of electronic charts. User feedback was sought pre and post go-live (during the COVID-19 pandemic) and financial implications were calculated by the hospital finance teams. Results Error rates equating to 219 000/year were avoided by conversion to electronic charts. Time saved was the equivalent of a nursing shift each day. Recurrent cost savings per year were estimated to be £257k. Staff were overwhelmingly positive about electronic charts in ICU, even during a health pandemic and despite redeployment into intensive care where they were using the electronic charts for the first time. Discussion Electronic ICU charts have been successfully introduced into our institution with benefits in terms of patient safety through error reduction and improved care through release of nursing time. Costs have been reduced. Staff feel supported by the digital system and report it to be helpful even during redeployment and in the unfamiliar environment of intensive care.

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Benefits of electronic charts in intensive care and during a world health pandemic: advantages of the technology age

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Benefits of electronic charts in intensive care and during a world health pandemic: advantages of the technology age