TY  - JOUR
N2  - Assessing illness severity in the ICU is crucial for early prediction of deterioration and prognosis. Traditional prognostic scores often treat organ systems separately, overlooking the body's interconnected nature. Network physiology offers a new approach to understanding these complex interactions. This study used the concept of transfer entropy (TE) to measure information flow between heart rate (HR), respiratory rate (RR), and capillary oxygen saturation (SpO2) in critically ill sepsis patients, hypothesizing that TE between these signals would correlate with disease outcome. The retrospective cohort study utilized the MIMIC III Clinical Database, including patients who met Sepsis-3 criteria on admission and had 30 minutes of continuous HR, RR, and SpO2 data. TE between the signals was calculated to create physiological network maps. Cox regression assessed the 48 relationship between cardiorespiratory network indices and both deterioration (SOFA score increase of ?2 points at 48 hours) and 30-day mortality. Among 164 patients, higher information flow from SpO2 to HR [TE(SpO2?HR)] and reciprocal flow between HR and RR [TE(RR?HR) and TE(HR?RR)] were linked to reduced mortality, independent of age, mechanical ventilation, SOFA score, and comorbidity. Reductions in TE(HR ? RR), TE(RR?HR), TE(SpO2?RR), and TE(SpO2?HR) were associated with increased risk of 48-hour deterioration. After adjustment for potential confounders, only TE(HR?RR) and TE(RR?HR) remained statistically significant. The study confirmed that physiological network mapping using routine signals in sepsis patients could indicate illness severity and that higher TE values were generally associated with improved outcomes. XXXX XXXX.
ID  - discovery10202632
UR  - https://doi.org/10.1152/japplphysiol.00642.2024
PB  - American Physiological Society
SN  - 8750-7587
JF  - Journal of Applied Physiology
A1  - Morandotti, Cecilia
A1  - Wikner, Matthew
A1  - Li, Qijun
A1  - Ito, Emily
A1  - Oyelade, Tope
A1  - Tan, Calix
A1  - Chen, Pin-Yu
A1  - Cawthorn, Anika
A1  - Lilaonitkul, Watjana
A1  - Mani, Ali R
KW  - Intensive Care
KW  -  Network physiology
KW  -  Sepsis
KW  -  Survival
KW  -  Transfer Entropy
TI  - Decreased cardio-respiratory information transfer is associated with deterioration and a poor prognosis in critically ill patients with sepsis
Y1  - 2024/12/16/
AV  - public
N1  - Copyright © 2025 The Authors.

Licensed under Creative Commons Attribution CC-BY 4.0. Published by the American Physiological Society.
ER  -