A Real-Time Artificial Intelligence-Assisted System to Predict Weaning from Ventilator Immediately after Lung Resection Surgery.

Ying-Jen Chang,Chao-Kun Chen,Li-Kai Wang,Chia-Hung Yu,Kuo-Chuan Hung,Jhi-Joung Wang,Hung-Tze Tay,Chung-Feng Liu

doi:10.3390/ijerph18052713

Abstract

Assessment of risk before lung resection surgery can provide anesthesiologists with information about whether a patient can be weaned from the ventilator immediately after surgery. However, it is difficult for anesthesiologists to perform a complete integrated risk assessment in a time-limited pre-anesthetic clinic. We retrospectively collected the electronic medical records of 709 patients who underwent lung resection between 1 January 2017 and 31 July 2019. We used the obtained data to construct an artificial intelligence (AI) prediction model with seven supervised machine learning algorithms to predict whether patients could be weaned immediately after lung resection surgery. The AI model with Naïve Bayes Classifier algorithm had the best testing result and was therefore used to develop an application to evaluate risk based on patients’ previous medical data, to assist anesthesiologists, and to predict patient outcomes in pre-anesthetic clinics. The individualization and digitalization characteristics of this AI application could improve the effectiveness of risk explanations and physician–patient communication to achieve better patient comprehension.

Highlights

Introduction published maps and institutional affilLung cancer has the highest mortality rate among all cancers in Taiwan [1]
Patients were divided into two groups according to whether they underwent stage weaning or not: 555 patients were weaned from the endotracheal tube immediately after the operation, and 154 patients failed to wean immediately and were transferred to the ICU for stage weaning
Pre-anesthetic consultation is a critical step in the pre-operative period, especially for risk assessment if patients cannot wean immediately, requiring high concentration oxygenation and stage weaning in the ICU

Summary

Introduction

Introduction published maps and institutional affilLung cancer has the highest mortality rate among all cancers in Taiwan [1]. The standard treatment for lung cancer is tumor resection surgery before cancer cell metastasis. Lung cancer is most often detected in the metastatic stage [2]. Only a small percentage of patients with lung cancer can undergo surgery. Lung resection is one of the riskiest major surgeries and must be performed under general anesthesia with advanced anesthetic monitoring [3]. Patients undergoing lung resection surgery must receive endotracheal tube intubation, which provides access to mechanical ventilation via a machine called a ventilator. If a patient can be weaned from the support of the endotracheal tube and the mechanical ventilator immediately after lung resection surgery (referred below as “wean immediately”), they can be sent back to the general ward for postoperative care; otherwise, they should be transferred to the intensive iations

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