eprintid: 10202632 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/20/26/32 datestamp: 2024-12-20 15:31:46 lastmod: 2024-12-20 15:31:46 status_changed: 2024-12-20 15:31:46 type: article metadata_visibility: show sword_depositor: 699 creators_name: Morandotti, Cecilia creators_name: Wikner, Matthew creators_name: Li, Qijun creators_name: Ito, Emily creators_name: Oyelade, Tope creators_name: Tan, Calix creators_name: Chen, Pin-Yu creators_name: Cawthorn, Anika creators_name: Lilaonitkul, Watjana creators_name: Mani, Ali R title: Decreased cardio-respiratory information transfer is associated with deterioration and a poor prognosis in critically ill patients with sepsis ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 keywords: Intensive Care, Network physiology, Sepsis, Survival, Transfer Entropy note: Copyright © 2025 The Authors. Licensed under Creative Commons Attribution CC-BY 4.0. Published by the American Physiological Society. abstract: 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. date: 2024-12-16 date_type: published publisher: American Physiological Society official_url: https://doi.org/10.1152/japplphysiol.00642.2024 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2344107 doi: 10.1152/japplphysiol.00642.2024 lyricists_name: Mani, Alireza lyricists_name: Oyelade, Tope lyricists_id: AMANI97 lyricists_id: TOYEL47 actors_name: Oyelade, Tope actors_id: TOYEL47 actors_role: owner full_text_status: public publication: Journal of Applied Physiology event_location: United States issn: 8750-7587 citation: Morandotti, Cecilia; Wikner, Matthew; Li, Qijun; Ito, Emily; Oyelade, Tope; Tan, Calix; Chen, Pin-Yu; ... Mani, Ali R; + view all <#> Morandotti, Cecilia; Wikner, Matthew; Li, Qijun; Ito, Emily; Oyelade, Tope; Tan, Calix; Chen, Pin-Yu; Cawthorn, Anika; Lilaonitkul, Watjana; Mani, Ali R; - view fewer <#> (2024) Decreased cardio-respiratory information transfer is associated with deterioration and a poor prognosis in critically ill patients with sepsis. Journal of Applied Physiology 10.1152/japplphysiol.00642.2024 <https://doi.org/10.1152/japplphysiol.00642.2024>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10202632/1/morandotti-et-al-2024-decreased-cardio-respiratory-information-transfer-is-associated-with-deterioration-and-a-poor.pdf