A novel artificial intelligence based intensive care unit monitoring system: using physiological waveforms to identify sepsis. (13th December 2021)

• Record Type: Journal Article
• Authors: Mollura, Maximiliano; Lehman, Li-Wei H.; Mark, Roger G.; Barbieri, Riccardo
• Is Part Of: Philosophical transactions. Volume 379:Number 2212(2021)
• Publication Date: 2021-12-13
• Subjects: cardiovascular modelling -- multimodal data -- continuous monitoring -- intensive care unit -- machine learning -- sepsis; Physical sciences -- Periodicals; Engineering -- Periodicals; Mathematics -- Periodicals; 500
• DOI: 10.1098/rsta.2020.0252
• Languages: English
• ISSNs: 1364-503X

Abstract

Abstract : A massive amount of multimodal data are continuously collected in the intensive care unit (ICU) along each patient stay, offering a great opportunity for the development of smart monitoring devices based on artificial intelligence (AI). The two main sources of relevant information collected in the ICU are the electronic health records (EHRs) and vital sign waveforms continuously recorded at the bedside. While EHRs are already widely processed by AI algorithms for prompt diagnosis and prognosis, AI-based assessments of the patients' pathophysiological state using waveforms are less developed, and their use is still limited to real-time monitoring for basic visual vital sign feedback at the bedside. This study uses data from the MIMIC-III database (PhysioNet) to propose a novel AI approach in ICU patient monitoring that incorporates features estimated by a closed-loop cardiovascular model, with the specific goal of identifying sepsis within the first hour of admission. Our top benchmark results (AUROC = 0.92, AUPRC = 0.90) suggest that features derived by cardiovascular control models may play a key role in identifying sepsis, by continuous monitoring performed through advanced multivariate modelling of vital sign waveforms. This work lays foundations for a deeper data integration paradigm which will help clinicians in their decision-making processes. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.