Jin Xin, Frock Andrew, Nagaraja Sridevi, Wallqvist Anders, Reifman Jaques
Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States.
The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, United States.
Front Physiol. 2024 Jan 25;15:1327948. doi: 10.3389/fphys.2024.1327948. eCollection 2024.
A deep neural network-based artificial intelligence (AI) model was assessed for its utility in predicting vital signs of hemorrhage patients and optimizing the management of fluid resuscitation in mass casualties. With the use of a cardio-respiratory computational model to generate synthetic data of hemorrhage casualties, an application was created where a limited data stream (the initial 10 min of vital-sign monitoring) could be used to predict the outcomes of different fluid resuscitation allocations 60 min into the future. The predicted outcomes were then used to select the optimal resuscitation allocation for various simulated mass-casualty scenarios. This allowed the assessment of the potential benefits of using an allocation method based on personalized predictions of future vital signs a static population-based method that only uses currently available vital-sign information. The theoretical benefits of this approach included up to 46% additional casualties restored to healthy vital signs and a 119% increase in fluid-utilization efficiency. Although the study is not immune from limitations associated with synthetic data under specific assumptions, the work demonstrated the potential for incorporating neural network-based AI technologies in hemorrhage detection and treatment. The simulated injury and treatment scenarios used delineated possible benefits and opportunities available for using AI in pre-hospital trauma care. The greatest benefit of this technology lies in its ability to provide personalized interventions that optimize clinical outcomes under resource-limited conditions, such as in civilian or military mass-casualty events, involving moderate and severe hemorrhage.
评估了一种基于深度神经网络的人工智能(AI)模型在预测出血患者生命体征以及优化大规模伤亡事件中液体复苏管理方面的效用。通过使用心肺计算模型生成出血伤亡的合成数据,创建了一个应用程序,其中有限的数据流(生命体征监测的最初10分钟)可用于预测未来60分钟不同液体复苏分配的结果。然后,利用预测结果为各种模拟的大规模伤亡场景选择最佳的复苏分配方案。这使得能够评估基于未来生命体征个性化预测的分配方法相对于仅使用当前可用生命体征信息的基于静态人群的方法的潜在益处。这种方法的理论益处包括多挽救高达46%的伤亡人员使其生命体征恢复正常,以及液体利用效率提高119%。尽管该研究无法避免与特定假设下的合成数据相关的局限性,但这项工作证明了在出血检测和治疗中纳入基于神经网络的AI技术的潜力。所使用的模拟损伤和治疗场景描绘了在院前创伤护理中使用AI的可能益处和机会。这项技术的最大好处在于其能够在资源有限的情况下提供个性化干预措施以优化临床结果,例如在涉及中度和重度出血的平民或军事大规模伤亡事件中。