Automated detection and classification of patient-ventilator asynchrony by means of machine learning and simulated data.

Mechanical ventilation Neural network Patient–ventilator asynchrony Synthetic data

Journal

Computer methods and programs in biomedicine
ISSN: 1872-7565
Titre abrégé: Comput Methods Programs Biomed
Pays: Ireland
ID NLM: 8506513

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 14 11 2022
revised: 20 12 2022
accepted: 31 12 2022
pubmed: 15 1 2023
medline: 22 2 2023
entrez: 14 1 2023
Statut: ppublish

Résumé

Mechanical ventilation is a lifesaving treatment for critically ill patients in an Intensive Care Unit (ICU) or during surgery. However, one potential harm of mechanical ventilation is related to patient-ventilator asynchrony (PVA). PVA can cause discomfort to the patient, damage to the lungs, and an increase in the length of stay in the ICU and on the ventilator. Therefore, automated detection algorithms are being developed to detect and classify PVAs, with the goal of optimizing mechanical ventilation. However, the development of these algorithms often requires large labeled datasets; these are generally difficult to obtain, as their collection and labeling is a time-consuming and labor-intensive task, which needs to be performed by clinical experts. In this work, we aimed to develop a computer algorithm for the automatic detection and classification of PVA. The algorithm employs a neural network for the detection of the breath of the patient. The development of the algorithm was aided by simulations from a recently published model of the patient-ventilator interaction. The proposed method was effective, providing an algorithm with reliable detection and classification results of over 90% accuracy. Besides presenting a detection and classification algorithm for a variety of PVAs, here we show that using simulated data in combination with clinical data increases the variability in the training dataset, leading to a gain in performance and generalizability. In the future, these algorithms can be utilized to gain a better understanding of the clinical impact of PVAs and help clinicians to better monitor their ventilation strategies.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Mechanical ventilation is a lifesaving treatment for critically ill patients in an Intensive Care Unit (ICU) or during surgery. However, one potential harm of mechanical ventilation is related to patient-ventilator asynchrony (PVA). PVA can cause discomfort to the patient, damage to the lungs, and an increase in the length of stay in the ICU and on the ventilator. Therefore, automated detection algorithms are being developed to detect and classify PVAs, with the goal of optimizing mechanical ventilation. However, the development of these algorithms often requires large labeled datasets; these are generally difficult to obtain, as their collection and labeling is a time-consuming and labor-intensive task, which needs to be performed by clinical experts.
METHODS METHODS
In this work, we aimed to develop a computer algorithm for the automatic detection and classification of PVA. The algorithm employs a neural network for the detection of the breath of the patient. The development of the algorithm was aided by simulations from a recently published model of the patient-ventilator interaction.
RESULTS RESULTS
The proposed method was effective, providing an algorithm with reliable detection and classification results of over 90% accuracy. Besides presenting a detection and classification algorithm for a variety of PVAs, here we show that using simulated data in combination with clinical data increases the variability in the training dataset, leading to a gain in performance and generalizability.
CONCLUSIONS CONCLUSIONS
In the future, these algorithms can be utilized to gain a better understanding of the clinical impact of PVAs and help clinicians to better monitor their ventilation strategies.

Identifiants

pubmed: 36640603
pii: S0169-2607(22)00714-3
doi: 10.1016/j.cmpb.2022.107333
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107333

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Conflict of Interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. F.M. has received fees for lectures from GE Healthcare, Hamilton Medical, Seda Spa. F.M. has a consultancy agreement between the University of Pavia and Hamilton Medical.

Auteurs

Tom Bakkes (T)

Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, the Netherlands. Electronic address: t.h.g.f.bakkes@tue.nl.

Anouk van Diepen (A)

Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, the Netherlands.

Ashley De Bie (A)

Catharina Ziekenhuis Eindhoven, Michelangelolaan 2, 5623 EJ Eindhoven, the Netherlands.

Leon Montenij (L)

Catharina Ziekenhuis Eindhoven, Michelangelolaan 2, 5623 EJ Eindhoven, the Netherlands.

Francesco Mojoli (F)

Department of Diagnostic, University of Pavia, S.da Nuova, 65, 27100 Pavia, Italy.

Arthur Bouwman (A)

Catharina Ziekenhuis Eindhoven, Michelangelolaan 2, 5623 EJ Eindhoven, the Netherlands.

Massimo Mischi (M)

Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, the Netherlands.

Pierre Woerlee (P)

Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, the Netherlands.

Simona Turco (S)

Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, the Netherlands.

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