Nagpal Chirag, Li Xinyu, Pinsky Michael R, Dubrawski Artur
Auton Lab, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA.
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Proc Mach Learn Res. 2019 Aug;106:109-123.
Rapid detection of hemorrhage is of major interest to the critical care community, enabling clinicians to take swift actions to mitigate adverse outcomes. In this paper, we describe a model that allows rapid detection of the onset of hemorrhage by monitoring the Central Venous Pressure (CVP). As opposed to prior work in the domain, our model does not rely on prior availability of a stable physiology of a patient as a baseline of reference, and it makes generative assumptions on the monitored vital sign. This allows for rapid on-the-fly personalization to a previously unseen patient's physiology. This property makes the proposed approach particularly relevant to e.g. trauma care and other scenarios where reference hemodynamic data may not be readily available for any new patient. We compare our model against strong discriminative alternatives and demonstrate its potential utility through empirical evaluation.
快速检测出血情况是重症监护领域的主要关注点,这使临床医生能够迅速采取行动以减轻不良后果。在本文中,我们描述了一种通过监测中心静脉压(CVP)来快速检测出血开始的模型。与该领域先前的工作不同,我们的模型不依赖于患者稳定生理状态作为参考基线的预先可用性,并且对监测到的生命体征做出生成性假设。这允许对先前未见过的患者生理状态进行快速实时个性化。此特性使得所提出的方法特别适用于例如创伤护理和其他新患者可能无法轻易获得参考血流动力学数据的场景。我们将我们的模型与强大的判别式替代方案进行比较,并通过实证评估证明其潜在效用。