The clinical study of spectral entropy in predicting the prognosis of children with early sedation and mechanical ventilation
10.3760/cma.j.issn.1673-4912.2025.09.006
- VernacularTitle:频谱熵监测在早期镇静的机械通气患儿预后预测中的临床研究
- Author:
Xulong LIU
1
;
Lijie WANG
1
Author Information
1. 中国医科大学附属盛京医院儿童急诊与重症医学科，沈阳 110004
- Publication Type:Journal Article
- Keywords:
Spectral entropy;
Depth of sedation;
Mechanical ventilation;
Prognosis
- From:
Chinese Pediatric Emergency Medicine
2025;32(9):668-673
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the validity of spectral entropy as a quantitative tool for assessing sedation depth in mechanically ventilated pediatric patients and to investigate its prognostic value in predicting clinical outcomes among children with pneumonia requiring early sedation.Methods:A total of 31 mechanically ventilated children admitted to the Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University from December 2021 to December 2022 were enrolled.Patients were stratified into deep sedation (Ramsay score ≥5) and light sedation (Ramsay score ≤4) groups.For children with concurrent pneumonia,prognosis was evaluated using a modified PIRO (Predisposition,Insult,Response,Organ dysfunction) score,and patients were further classified into favorable-prognosis group and poor-prognosis group.Clinical characteristics,outcomes,and spectral entropy values were compared across groups.Receiver operating characteristic (ROC) curve analysis was performed to assess the prognostic predictive capacity of spectral entropy and Ramsay scores.Results:Spectral entropy exhibited a strong negative correlation with Ramsay scores ( r s2=-0.787, P < 0.001).The deep sedation group demonstrated significantly lower spectral entropy values compared to the light sedation group (34.0±1.0 vs.52.7±6.3, P<0.001).Among children with pneumonia,the favorable-prognosis group showed higher spectral entropy values than the poor-prognosis group (49.5±8.0 vs.42.1±10.4, P=0.047).Additionally,the hospitalization time of the poor-prognosis group was higher than that of the favorable-prognosis group [20.5(9.0,36.0)days vs.14.0(12.0,18.0)days],although the difference was not statistically significant ( P=0.191).Mechanical ventilation duration was significantly shorter in the favorable-prognosis group versus the poor-prognosis group [(151.7±41.2)hours vs.(414.9±264.1)hours, P=0.012] .Modified PIRO scores correlated positively with Ramsay scores ( r s2=0.367, P＝0.042),and negatively with spectral entropy ( r s2=-0.363, P＝0.045).ROC analysis revealed that Ramsay scores (AUC=0.329,sensitivity 50.0%,specificity 84.2%) and spectral entropy (AUC=0.715,sensitivity 100.0%,specificity 50.0%) provided statistically significant prognostic discrimination ( P<0.05),with optimal cutoff values of 4.5 and 34.6,respectively. Conclusion:Spectral entropy correlates robustly with Ramsay scores,demonstrating its utility as an objective,quantitative tool for monitoring sedation depth in mechanically ventilated children.Furthermore,spectral entropy shows potential as a direct and reliable electrophysiological biomarker for predicting clinical outcomes in pediatric pneumonia patients receiving early sedation.
