基于机器学习的中心静脉压升高的患者的识别,使用从光电脉冲图波形中提取的特征
Ravi Pal1, Akos Rudas2, Jeffrey N Chiang2
1Department of Anesthesiology & Perioperative Medicine, University of California, Los Angeles, CA, USA.
medRxiv : the preprint server for health sciences
|January 8, 2026
概括
机器学习分析光聚缩学 (PPG) 信号可以非侵入性地识别升高的中央静脉压力 (CVP). 这种方法显示了在重症监护中传统的CVP监测的潜在更少入侵的替代方案.
科学领域:
- 生物医学工程 生物医学工程
- 关键护理医学 关键护理医学
- 机器学习应用 机器学习应用
背景情况:
- 中心静脉压 (CVP) 对于重症患者的血液动力学监测和液体复苏至关重要.
- 目前通过导管测量CVP是侵入性的,耗时的,并带有风险.
- 需要使用非侵入性方法来评估CVP.
研究的目的:
- 调查使用机器学习 (ML) 来分析非侵入性光电显微镜 (PPG) 信号以检测升高的CVP的可行性.
- 开发和验证一种能够使用PPG特征区分正常和升高CVP的ML模型.
主要方法:
- 一种轻度梯度增强机器 (LightGBM) 模型在1665名同时使用PPG和CVP波形的患者的大型外科手术数据集 (MLORD) 上进行了训练.
- 每个心脏周期抽取了843个PPG特征,以及每个患者的平均值和标准偏差特征.
- 递归特征消除与交叉验证 (RFECV) 选择了246个特征;超参数进行了调整,并使用引导来验证模型.
主要成果:
- 轻GBM分类器在接收器操作特征曲线 (AUC) 下的平均面积为0.79 (95%CI:0.71-0.84).
- 平均准确率为0.71 (95% CI:0.65-0.77),表明了良好的区分能力.
- 该模型成功地区分了正常的 (515 mmHg) 和升高的 (CVP>15 mmHg) CVP.
结论:
- 当通过ML分析PPG衍生特征时,可以有效地区分正常和升高的CVP.
- 这项研究表明了非侵入性PPG分析作为侵入性CVP监测的替代品的潜力.
- 这些发现为在临床实践中开发新的非侵入性CVP评估工具铺平了道路.
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