Deep learning for time-series segmentation of mechanical ventilator waveforms

Accurate segmentation of ventilator waveforms is essential for detecting patient-ventilator asynchronies (PVAs), yet current heuristic methods can fail in noisy, real-world data. We developed and validated a deep learning model using a one-dimensional attention-gated U-Net architecture to identify inspiratory and expiratory onsets in mechanical ventilation waveforms. The model was trained and tested on 9719 breaths from 33 patients and outperformed published rule-based methods, achieving F1 scores of > 0.99 for both inspiratory and expiratory onset detection within a 0.1-s tolerance window. Performance remained robust in asynchronous breaths (F1 ≥ 0.98). When applied to quantify PVAs, the model reproduced reference standard asynchrony frequencies with no significant differences, whereas heuristic methods produced large deviations. Gradient-weighted class activation maps suggest that the model leveraged a diverse set of waveform features to inform segmentation. This computationally efficient model enables highly-accurate, clinically timely waveform analysis and provides a foundation for scalable, reproducible assessment of ventilator-patient interactions.