Combining Chest X-Ray and Arterial Blood Gas Findings to Predict Need for Mechanical Ventilation in Critically Ill Patients

The study is a prospective cross-sectional investigation conducted at Zagazig University Hospitals, aiming to develop a machine learning model that integrates chest X-ray findings and arterial blood gas (ABG) analysis to assess the necessity for mechanical ventilation in critically ill adult patients. While current clinical decision-making relies on separate interpretation of radiologic and biochemical data, this study proposes a novel model that synthesizes both sources of information using artificial intelligence to improve predictive accuracy and reduce subjectivity.

A total of approximately 2,160 patients will be enrolled over a 6-month period. Data collected will include demographic and clinical characteristics, ABG parameters (e.g., pH, PaO2, PaCO2, HCO3), and radiological features (e.g., infiltrates, effusions, consolidation). Patients will be categorized based on whether they require mechanical ventilation.

The machine learning model will be trained on 70% of the dataset and validated on the remaining 30%. Performance metrics such as accuracy, R-squared values, and root mean square error (RMSE) will be used to assess predictive capacity. The study will adhere to ethical guidelines and has obtained IRB approval from the Faculty of Medicine at Zagazig University (Approval No. 1138).

By combining imaging and laboratory data, this study seeks to deliver a practical decision-support tool that enhances the objectivity and efficiency of critical care management.

Inclusion criteria

Critically ill adult patients aged 18 years or older.

Patients assessed to require mechanical ventilation.

Control group: Age- and sex-matched critically ill patients not requiring mechanical ventilation.

Availability of both chest X-ray and arterial blood gas (ABG) analysis at the time of evaluation.

Exclusion criteria

Patients with missing or incomplete data (e.g., absent chest X-ray or ABG results).

Patients with chronic lung diseases unrelated to the current admission (e.g., COPD, pulmonary fibrosis).

Pregnant females.