A Signal Processing Approach for Detection of Hemodynamic Instability before Decompensation
Ashwin Belle, Sardar Ansari, Maxwell Spadafore, Victor A Convertino, Kevin R Ward, Harm Derksen, Kayvan Najarian, Ashwin Belle, Sardar Ansari, Maxwell Spadafore, Victor A Convertino, Kevin R Ward, Harm Derksen, Kayvan Najarian
Abstract
Advanced hemodynamic monitoring is a critical component of treatment in clinical situations where aggressive yet guided hemodynamic interventions are required in order to stabilize the patient and optimize outcomes. While there are many tools at a physician's disposal to monitor patients in a hospital setting, the reality is that none of these tools allow hi-fidelity assessment or continuous monitoring towards early detection of hemodynamic instability. We present an advanced automated analytical system which would act as a continuous monitoring and early warning mechanism that can indicate pending decompensation before traditional metrics can identify any clinical abnormality. This system computes novel features or bio-markers from both heart rate variability (HRV) as well as the morphology of the electrocardiogram (ECG). To compare their effectiveness, these features are compared with the standard HRV based bio-markers which are commonly used for hemodynamic assessment. This study utilized a unique database containing ECG waveforms from healthy volunteer subjects who underwent simulated hypovolemia under controlled experimental settings. A support vector machine was utilized to develop a model which predicts the stability or instability of the subjects. Results showed that the proposed novel set of features outperforms the traditional HRV features in predicting hemodynamic instability.
Conflict of interest statement
Competing Interests: The authors have read the journal’s policy and the following authors of this manuscript have the following competing interests: AB KN KW HD: Invention disclosure, (pending) patents pertinent to the product in development (on the algorithm described in this manuscript filed through the University of Michigan’s Office of Technology Transfer. The patent filing is currently under review: U.S. Application No. 14/751,260; Title: Early Detection of Hemodynamic Decompensation Using Taut-String Transformation"). The following authors have declared that no competing interests exist: MS SA VC. This does not alter the authors’ adherence to all PLOS ONE policies on sharing data and materials.
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References
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