使用基于非侵入性监测设备的深度学习模型预测手术内低血压
Heejoon Jeong1, Donghee Kim2, Dong Won Kim2
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
Journal of clinical monitoring and computing
|August 19, 2024
概括
这项研究开发了一种使用非侵入性监视器的深度学习算法,用于预测手术内低血压,实现高精度. 该模型可以帮助临床医生在手术期间主动管理血压.
科学领域:
- 麻醉学 麻醉学
- 生物医学工程 生物医学工程
- 人工智能在医学中的应用
背景情况:
- 术后低血压与患者的不良结果有关.
- 低血压的预测模型通常依赖于侵入性监测.
- 开发非侵入性预测方法对于更广泛的临床应用至关重要.
研究的目的:
- 开发和验证一种深度学习算法,用于使用非侵入式监视器预测手术内低血压.
- 评估算法在预测低血压事件中的准确性.
- 探索不同非侵入性监测器在预测模型中的贡献.
主要方法:
- 利用非心脏手术患者的开源数据库进行算法开发 (4754名患者).
- 使用来自韩国第三级医院 (421名患者) 的外部数据验证了算法.
- 采用深度学习模型 (多头注意力,全局注意力局部反复) 与非侵入性数据 (NIBP,ECG,PPG,头部图谱,BIS) 预测低血压 (SBP <90 mmHg) 提前5分钟.
主要成果:
- 深度学习模型实现了开发数据的接收器运行特征曲线 (AUROC) 下的面积为0.917,外部验证数据为0.833.
- 该算法成功预测了手术内低血压在发生5分钟前.
- 注意地图表明,该算法利用了所有五个非侵入性监测器的数据,个体贡献范围从8%到22%.
结论:
- 集成多道非侵入性监测的深度学习模型有效地预测高准确度的手术内低血压.
- 需要进一步的前性研究来证实该模型在预防手术期间低血压方面的临床实用性.
- 人工智能可以利用非侵入性监测数据来提高手术过程中患者的安全性.
相关概念视频
Equipments Used To Measure Blood Pressure
Direct Method
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
Errors occurring during blood pressure monitoring
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
Assessing Blood pressure using a doppler ultrasound
To obtain accurate blood pressure measurements in clinical settings, especially when traditional methods are insufficient, healthcare professionals utilize the Doppler ultrasound technique. This method uses high-frequency sound waves to detect blood flow within the arteries, which is crucial for patients with conditions that complicate circulatory system assessment.
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Assessing Blood Pressure
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.


