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Deep Neural Network-Driven Early Recognition in Cardiopulmonary Failure: A Paradigm Shift Underway in Temporary
Monika Tukacs1,2, Elena Giovanna Bignami3, Patrick M Wieruszewski4,5
1ECMO Program for Adults and Pediatrics, New York Presbyterian/Weill Cornell Medicine, New York, New York, USA.
Abstract:
The contemporary intensive care unit generates an overwhelming magnitude of high-frequency, granular physiological data. However, conventional decision-making for patients requiring temporary mechanical circulatory support (tMCS) remains tethered to reactive, threshold-driven manual adjustments, underutilizing continuous data streams and failing to optimize the complex patient-machine interaction. This review examines the integration of deep neural networks (DNNs) as a candidate strategy for advanced clinical decision support. By identifying a continuous "digital phenotype," hierarchical deep learning architectures signal a shift toward real-time trajectory recognition in tMCS. We establish a four-tier functional taxonomy-prognosticative, descriptive, predictive, and prescriptive-to categorize translational milestones from automated pump-speed optimization to closed-loop homeostatic regulation. Operational challenges are analyzed through the TEIP (Transparency, Explainability, Interpretability, and Performance) Core-Lens Framework, navigating the dynamic equilibrium between computational density and clinical explainability. We further evaluate the evolving global regulatory landscape, advocating for a foundation on verified empirical safety and rigorous clinical trial validation over absolute mathematical transparency in high-density architectures. Implementing a strategic roadmap including context-specific validation, multimodal integration, and human-centered design is quintessential to safely transform passive hardware into intelligent systems. As the field evolves, DNN technology offers a consequential opportunity to advance early cardiopulmonary failure recognition into a clinical reality.
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