Child Health

Using Machine Learning to Make Ventilator Support Safer for Children

Published

1 year ago

August 14, 2023

Daily News Staff

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Robinder Khemani, MD, MsCI, Attending Physician in Pediatric Intensive Care at Children’s Hospital Los Angeles has received a $3.4 million grant from the National Institute of Health to examine to improve outcomes of children put on ventilators.
*« Using Machine Learning to Make Ventilator Support Safer for Children*

Newswise — LOS ANGELES — Critically ill children on ventilator support can experience a mismatch between their breathing efforts and) the rhythm delivered by the ventilator. This mismatch, called patient-ventilator asynchrony (PVA), is difficult to detect and can worsen patient outcomes. PVA is commonly associated with longer stays on a ventilator for adults and can raise the risks of infection, lung injury and brain damage. However, little is known about PVA in children, where it could be just as, if not more, common. Robinder Khemani, MD, MsCI, Attending Physician in Pediatric Intensive Care at Children’s Hospital Los Angeles, is using machine learning to improve the outcomes of children put on ventilators.

A CHLA research team led by Dr. Khemani has received a $3.4 million grant from the National Institutes of Health to examine the frequency and risk factors for common types of PVA in critically ill children. Working with hospitals in Canada and the Netherlands, the researchers will investigate whether PVA is independently associated with poor clinical outcomes and determine the effects on the body when breathing doesn’t match the flow of air provided by the ventilator.

Children can need ventilator support for multiple reasons, including severe pneumonia or acute respiratory distress syndrome (ARDS), when infection or trauma causes swelling, inflammation and fluid buildup in the lungs. The body’s response to the initial injury can harm the lungs even more than the infection or trauma itself.

“Many of these very sick patients can develop unexpected complications from the very procedures that we use to help them,” says Dr. Khemani. Ventilator-induced lung injury can lead to heart and kidney damage, or can increase vulnerability to future lung disease, asthma or sleep-disordered breathing.

“Brain function can also be impaired by all the medications, anesthetics and sedation patients receive to help them to tolerate the ventilator,” says Dr. Khemani. “We weigh the risks and benefits to minimize potential harms and hopefully get them off the ventilator as soon as they are ready.”

Measuring patient-ventilator mismatch
“There are many types of PVA, but we still don’t know which PVA subtypes are most harmful or are the most frequent,” says Dr. Khemani. “We need to develop a common set of definitions and measurements, especially for pediatric patients.”

Mismatches between patient breathing and the rhythm the ventilator provides can occur in different ways, as children’s breathing varies according to their weight, size and age. Respiration patterns can also change during the course of a child’s stay in the pediatric intensive care unit. But existing studies use different definitions for PVA subtypes and no study so far has been large enough to evaluate the relationship between different types of PVA and patient outcomes, or has yet focused on the highest-risk patients.

Automating ventilator-patient breathing
“It takes a very highly trained human to recognize PVA,” says Dr. Khemani. “But computers can do this very well. Our colleagues at the Virtual Pediatric Intensive Care Unit (vPICU) here at CHLA have been working with us on this project for a few years and have developed machine-learning algorithms that can identify different types of breathing asynchronies in children on ventilators.”

The study team will collect measurements from 200 children and combine this data with the analysis of 350 children in other studies, including a clinical trial that is testing a novel ventilator strategy. “By the end of this project, we hope to have developed these algorithms and validate that they work in three different hospitals using data from many different children,” says Dr. Khemani. “Simultaneously we will build a tool to automatically detect PVA by analyzing ventilator data through machine-learning algorithms. We will test how well the tool helps providers to identify the minute-to-minute changes in patients and potentially alert the bedside team that an adjustment to the ventilator may be needed.”

To minimize the risks of ventilator support, medical teams want to keep patients participating in breathing for themselves as much as possible. “So that’s where this study really comes into play, by constantly tracking the interaction between the child and the ventilator to ask if the ventilator is supplying just the right amount of help, precisely when needed,” says Dr. Khemani.

About Children’s Hospital Los Angeles
Founded in 1901, Children’s Hospital Los Angeles is the largest provider of hospital care for children in California. Renowned pediatric experts work together across disciplines to deliver inclusive and compassionate health care to one of the world’s most diverse populations, driving advances that set child health standards across the nation and around the globe. With a mission to create hope and build healthier futures for children, the hospital consistently ranks in the top 10 in the nation, No. 1 in California and No. 1 in the Pacific U.S. region on U.S. News & World Report’s Honor Roll of Best Children’s Hospitals. The Saban Research Institute of Children’s Hospital Los Angeles supports the full continuum of child health research and is among the top 10 pediatric academic medical centers for National Institutes of Health funding, meaning physicians and scientists translate discoveries into treatments and bring answers to families faster. Home to one of the largest pediatric training programs in the United States, Children’s Hospital Los Angeles graduates a new class of physicians each year who have learned world-class children’s health care at the forefront of medicine. And as an anchor institution, the hospital strengthens the economic health of surrounding communities by fighting food insecurity, enhancing health education and literacy, and introducing early careerists to health care. To learn more, follow us on Facebook, Instagram, LinkedIn, YouTube and Twitter, and visit our blog at CHLA.org/blog.

Source: Children’s Hospital Los Angeles

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Lifestyle

Back-to-School Checklist: Ensuring a Healthy Start to the School Year

Published

2 weeks ago

August 29, 2024

Rebecca Washington

As summer winds down, the buzz of back-to-school preparations begins. It’s a time filled with shopping for school supplies, adjusting to earlier bedtimes, and setting up kids for a successful school year. While we often think of pencils, notebooks, and new backpacks, there’s another crucial aspect to consider—your child’s health. Ensuring they are physically and mentally prepared is just as important as having the right school supplies. Here’s a comprehensive health checklist parents should consider to ensure their children are set up for a healthy school year.

boy looking on a tidied desk at school. — Photo by Oleksandr P on Pexels.com

Annual Physicals and Required Paperwork

A yearly physical exam is essential to assess your child’s health and development. It’s a perfect time to update any necessary medication plans with the school nurse and handle all the required health paperwork. These exams are vital for catching health issues before they become problematic, ensuring your child is in the best shape to start the school year.

Up-to-Date Vaccinations

Make sure your child’s vaccinations are current. This not only includes the standard childhood vaccines but also the flu shot, COVID-19 vaccinations, and possibly the HPV vaccine. Checking in with your pediatrician can help clarify what vaccinations your child needs before heading back to school.

Focus on Mental Health

The transition back to school can be a stressful time for children and teens, potentially triggering anxiety and depression. Observing your child’s behavior for signs of stress and discussing any concerns with health professionals can help manage these issues early. Regular conversations about their feelings can also make a big difference.

Sports Physicals

For children involved in sports, a specific physical examination is necessary to ensure they can safely participate in physical activities. This physical includes assessments of overall health with a focus on cardiac and pulmonary functions, which are crucial for preventing emergencies such as sudden cardiac arrests in young athletes.

Concussion Awareness

Parents and young athletes should be informed about the risks and signs of concussions—common in sports like football, soccer, and cheerleading. Knowing what symptoms to look for and how to respond if a concussion occurs is essential for every parent and coach.

Proper Sleep Habits

Adequate sleep is foundational for academic success and overall health. Establishing a solid bedtime routine that allows for enough sleep is crucial. This might also mean making the bedroom a screen-free zone to avoid the sleep-disrupting effects of blue light from electronics.

Backpack Safety

Choose a lightweight backpack and ensure that it does not exceed 20% of your child’s body weight to avoid back problems. Opting for designs with padded shoulder straps and a waist belt can distribute weight more evenly.

Regular Eye Exams

Vision problems can significantly affect a child’s learning ability. An annual eye exam can detect issues that might impair their ability to see clearly, which is vital for optimal learning. Even if your child has passed a school screening, a comprehensive eye exam by a professional can catch problems that screenings might miss.

Navigating Screen Time and Online Safety

As technology becomes more engrained in learning, managing screen time and understanding online safety becomes more important. Creating a media plan that balances educational and recreational screen time can help prevent sleep disruption and exposure to inappropriate content.

By integrating these health checks into your back-to-school preparations, you can help ensure your child has a healthy, productive year ahead. Remember, readiness for school isn’t just about having the right supplies—it’s also about being mentally and physically prepared for the challenges of a new academic year.

Source: Hackensack Meridian Health via Newswise

Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.

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Rebecca Washington

Rebecca Jo is a mother of four and is a creative soul from Phoenix, Arizona, who also enjoys new adventures. Rebecca Jo has a passion for the outdoors and indulges in activities like camping, fishing, hunting and riding roller coasters. She is married to Rod Washington View all posts

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Lifestyle

The Importance of Clean School Transportation

Published

3 weeks ago

August 26, 2024

Daily News Staff

The Importance of Clean School Transportation

(Family Features) Across the country, more than 25 million children ride to school each day in school buses, most of which are powered by diesel and produce harmful emissions known to cause respiratory issues like asthma and bronchitis.

An alternative energy source, like propane, can provide children with a safe, clean and healthy ride to school. As an environmentally friendly and affordable energy source that is abundantly available, propane can help achieve a cleaner today and greener tomorrow for students.

Watch this video to learn more!

https://youtube.com/watch?v=XT6vzCDdk8M%3Fsi%3DFU6ZLnpGfsIsjjUI

Consider these reasons it’s important to clean up student transportation from the experts at the Propane Education & Research Council:

Propane reduces emissions in exhaust that negatively impact air quality by up to 96% compared to diesel.
Propane school buses provide a quieter ride than diesel buses, which means it’s easier for drivers to hear potential concerns and students arrive at school calmer and ready to learn.
Propane warms up quickly, providing a heated cabin for a comfortable ride during colder months.
Propane is affordable, allowing school districts to replace aging diesel buses three times faster than transitioning to an electric bus fleet.

Learn more about clean transportation options and the benefits of propane school buses at BetterOurBuses.com .

SOURCE:
Propane Education & Research Council

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Lifestyle

Going Green in Your Community

Published

4 weeks ago

August 21, 2024

Daily News Staff

Community Efforts

(Family Features) Preserving your community for future generations can take many forms. It might mean volunteering with local organizations and participating in community improvement initiatives. Taking steps to protect the environment is another critical way to ensure your community remains safe and livable for generations to come.

These ideas show that going green can be as simple as making small modifications to everyday actions you already take.

Donating Unwanted Goods
Landfills are overflowing with items that still have plenty of useful life. Often, those discarded items could be repurposed to provide an affordable option to those who can’t afford new, full-price versions. Before loading up your trash can, consider donating things like household goods and clothing that could still serve a purpose. Numerous organizations accept gently used goods that they either distribute directly to those in need or sell to the general public, with proceeds benefiting a specific cause or population. Look into the options in your area to find the best fit for items you have that can be donated.

Rethinking Transportation
Pollution from transportation accounts for 29% of the United States’ emissions, according to the Environmental Protection Agency (EPA). That’s a higher percentage than any other category measured by the EPA. Carpooling, public transportation and even carefully planning your route are ways you can take personal accountability to help reduce the problem.

Another way to improve transportation emissions is by talking to your school district about its school bus choices. Diesel school buses are not only expensive to operate, but they are harmful to children’s health, the community and the climate, according to data compiled by the Propane Education & Research Council. Conversely, propane reduces harmful emissions that impact student health and air quality in the community. By advocating for your district to convert to a more environmentally friendly transportation option, such as propane, you can help further reduce harmful emissions in your community.

Find more information about propane-powered buses at BetterOurBuses.com.

Recycling and Composting
Another way to reduce landfill waste is recycling and composting. Many of the items you throw away can be recycled into all-new materials. For example, recycled plastic can be used in a wide range of products, from sleeping bags and backpacks to dishes and reusable water bottles. Food waste represents a large share of landfills, too. Eventually it will biodegrade, but composting what you can at home gives you nutrient-rich material you can use to support your garden or lawn with healthier soil and less need for pesticides.

Cleaning with Natural Products
Keeping your home clean takes more than a little elbow grease, but the harsh chemicals found in many household cleaners are actually quite damaging. The chemicals can be poisonous or contain allergens that negatively impact your home’s air quality. Natural cleaners are often more cost-efficient, so you can enjoy cleaner air and minimize your impact on the environment.

Taking Advantage of Natural Light
If you’re in the habit of flipping on a light switch as you walk in a room, next time pause and consider whether you really need additional light. During daylight hours, many rooms offer more than enough natural light. Sunlight can also help warm spaces naturally when it’s cool outdoors, so throw open the curtains and let those warm, bright rays shine. If you do need additional light, consider relying on task lighting to illuminate your project rather than an overhead light that consumes more electricity.

Benefits of Propane School Buses

Over the last several decades, there have been many advances in student transportation. However, one area that could still use improvement is the number of students who ride to school on diesel buses that pollute the air. Today, there are two meaningful energy choices for clean student transportation: propane and electric. While both can achieve clean transportation, propane buses cost one-third the price of electric, allowing districts to replace their aging diesel fleet faster.

As an affordable, available and clean energy source, propane buses make practical sense. The buses reduce harmful emissions by 96% compared to diesel. They can also meet school districts’ needs with a range of up to 400 miles and the resiliency to continue operating across all terrains and in any weather. In fact, more than 1,000 school districts have already made the switch. Every day, 1.3 million children ride to school in 22,000 propane school buses across the country.

In 2022, the EPA introduced the Clean School Bus Program, which provides $5 billion over five years (2022-26) to replace existing diesel school buses with zero-emission and low-emission models.

Through three rounds of funding, the EPA program has allocated more than $2.8 billion for 8,427 electric school buses and 440 low-emissions propane buses. However, for the same amount of money that was distributed for the electric buses (about $2.77 billion), the program could have helped fund as many as 92,635 propane buses, assuming each propane bus received the $30,000 incentive.

When considering full lifecycle emissions, replacing 92,635 diesel buses with propane buses would have reduced harmful nitrogen oxide (NOx) emissions by 24,664 metric tons over the three years the program has funded buses. By comparison, replacing just 8,427 diesel buses with electric buses will reduce NOx emissions by just 2,379 metric tons over the three years.

SOURCE:
Propane Education & Research Council