Transitions in intensive care: Investigating critical slowing down post extubation

• DOI: 10.1371/journal.pone.0317211
• Publication Date: 2025-01-24T18:28:02Z
• Authors: Lucinda Khalil; Sandip V. George; Katherine L. Brown; Samiran Ray; Simon Arridge
• Keywords: Science; Q; R; Medicine; Research Article

Complex biological systems undergo sudden transitions in their state, which are often preceded by a critical slowing down of dynamics. This results longer recovery times as approach transitions, quantified an increase measures such the autocorrelation and variance. In this study, we analysed paediatric patients intensive care for whom mechanical ventilation was discontinued through removal endotracheal tube (extubation). Some failed extubation, required re-intubation within 48 hours. We investigated whether could be observed post extubations, prior to re-intubation. tested significant increases ( p <.05) between extubation re-intubation, variance autocorrelation, over time series data heart rate, respiratory rate mean blood pressure. The showed significantly higher proportion group that compared who those did not. It also magnitude t-test. Moreover, incorporating these magnitudes improved fit logistic regression model when solely used standard deviation vital signs. While immediate clinical utility is limited, work marks important first step towards using dynamical theory understand dynamics signals measured at bedside during care.