Effect of a Machine Learning Algorithm to Guide Goal-Directed Therapy After Cardiac Surgery.

Background: Goal-directed therapy allows clinicians to optimize perfusion and volume status in patients postoperatively. Objective: To evaluate the effect of a machine learning algorithm to guide postoperative goal-directed fluid therapy in cardiac surgery patients. Methods: A goal-directed fluid th...

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Publicado en:American Journal of Critical Care Vol. 35; no. 5; pp. 378 - 384
Autores principales: Rea, Amanda, Deasel, Alexandra, Fonner, Clifford Edwin, Salenger, Rawn
Formato: CEU research tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Sep2026
Acceso en línea:Ver este registro en EBSCOhost
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        10623264
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      jtl: American Journal of Critical Care
      issn: 10623264
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      dt: Sep2026
      vid: 35
      iid: 5
      pid: 2559
      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        196600370
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        10.4037/ajcc2026587
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        atl: Effect of a Machine Learning Algorithm to Guide Goal-Directed Therapy After Cardiac Surgery.
      aug:
        au:
          Rea, Amanda
          Deasel, Alexandra
          Fonner, Clifford Edwin
          Salenger, Rawn
        affil: lead of advanced practice, clinical program manager, Division of Cardiac Surgery, University of Maryland St Joseph Medical Center, Towson, Maryland
      sug:
        subj:
          Machine Learning Algorithms
          Cardiac Surgery
          Fluid Therapy
          Surgical Patients Psychosocial Factors
          Postoperative Care
          Human
          Male
          Female
          Retrospective Design
          Prospective Studies
          Algorithms
          Unpaired T-Tests
          Chi Square Test
          Two-Tailed Test
          Comparative Studies
          Kidney Failure, Acute
          Incidence
          Patient Discharge
          Cost Savings
          Coronary Artery Bypass
          Education, Continuing (Credit)
          Male
          Female
      ab: Background: Goal-directed therapy allows clinicians to optimize perfusion and volume status in patients postoperatively. Objective: To evaluate the effect of a machine learning algorithm to guide postoperative goal-directed fluid therapy in cardiac surgery patients. Methods: A goal-directed fluid therapy program was implemented in a single center for coronary artery bypass patients with ejection fraction greater than or equal to 45% (implementation period: May 15, 2023, to May 31, 2024). Patient outcomes were compared with outcomes in matched historical control patients (control period: January 3 to October 31, 2022). The primary outcome was acute kidney injury. Results: A total of 479 eligible patients were evaluated (246 in the control group and 233 in the goal-directed therapy group). The incidence of acute kidney injury on postoperative day 2 (P =.01), on postoperative day 7(P =.02), and at discharge (P =.008) was lower in the goaldirected therapy group than in the control group. Conclusions: Patients in the goal-directed therapy program had a lower incidence of acute kidney injury compared with historical control patients. Incorporating a machine learning algorithm to guide goal-directed fluid therapy was a safe and less invasive way to monitor selected patients in the intensive care unit after cardiac surgery.
      pubtype: Academic Journal
      doctype:
        CEU
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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