Early detection of critical pulmonary shunts in infants

Radoslav Ivanov, James Weimer, Insup Lee, Allan Simpao, Mohamed Rehman

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

This paper aims to improve the design of modern Medical Cyber Physical Systems through the addition of supplemental noninvasive monitors. Specifically, we focus on monitoring the arterial blood oxygen content (CaO2). one of the most closely observed vital signs in operating rooms, currently measured by a proxy - peripheral hemoglobin oxygen saturation (SpO2). While SpO2 is a good estimate of O2content in the finger where it is measured, it is a delayed measure of its content in the arteries. In addition, it does not incorporate system dynamics and is a poor predictor of future CaO2 values. Therefore, as a first step towards sup-plementing the usage of SpO2, this work introduces a predictive monitor designed to provide early detection of critical drops in CaO2 caused by a pulmonary shunt in infants. To this end, we develop a formal model of the circulation of oxygen and carbon dioxide in the body, characterized by unknown patient-unique parameters. Employing the model, we design a matched subspace detector to provide a near constant false alarm rate invariant to these parameters and modeling uncertainties. Finally, we validate our approach on real-patient data from lung lobectomy surgeries performed at the Children's Hospital of Philadelphia. Given 198 infants, the detector predicted 81% of the critical drops in CaO2at an average of about 65 seconds earlier than the SpO2-based monitor, while achieving a 0.9% false alarm rate (representing about 2 false alarms per hour).

Original languageEnglish (US)
Title of host publicationACM/IEEE 6th International Conference on Cyber-Physical Systems, ICCPS 2015
PublisherAssociation for Computing Machinery, Inc
Pages110-119
Number of pages10
ISBN (Electronic)9781450334556
DOIs
StatePublished - Apr 14 2015
Event6th ACM/IEEE International Conference on Cyber-Physical Systems, ICCPS 2015 - Seattle, United States
Duration: Apr 14 2015Apr 16 2015

Publication series

NameACM/IEEE 6th International Conference on Cyber-Physical Systems, ICCPS 2015

Other

Other6th ACM/IEEE International Conference on Cyber-Physical Systems, ICCPS 2015
CountryUnited States
CitySeattle
Period4/14/154/16/15

ASJC Scopus subject areas

  • Computer Networks and Communications
  • Computer Science Applications
  • Hardware and Architecture

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  • Cite this

    Ivanov, R., Weimer, J., Lee, I., Simpao, A., & Rehman, M. (2015). Early detection of critical pulmonary shunts in infants. In ACM/IEEE 6th International Conference on Cyber-Physical Systems, ICCPS 2015 (pp. 110-119). (ACM/IEEE 6th International Conference on Cyber-Physical Systems, ICCPS 2015). Association for Computing Machinery, Inc. https://doi.org/10.1145/2735960.2735962