TY - GEN
T1 - Early detection of critical pulmonary shunts in infants
AU - Ivanov, Radoslav
AU - Weimer, James
AU - Lee, Insup
AU - Simpao, Allan
AU - Rehman, Mohamed
PY - 2015/4/14
Y1 - 2015/4/14
N2 - 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).
AB - 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).
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U2 - 10.1145/2735960.2735962
DO - 10.1145/2735960.2735962
M3 - Conference contribution
AN - SCOPUS:84941005524
T3 - ACM/IEEE 6th International Conference on Cyber-Physical Systems, ICCPS 2015
SP - 110
EP - 119
BT - ACM/IEEE 6th International Conference on Cyber-Physical Systems, ICCPS 2015
PB - Association for Computing Machinery, Inc
T2 - 6th ACM/IEEE International Conference on Cyber-Physical Systems, ICCPS 2015
Y2 - 14 April 2015 through 16 April 2015
ER -