Early prediction of respiratory failure in the intensive care unit

The development of respiratory failure is common among patients in intensive care units (ICU). Large data quantities from ICU patient monitoring systems make timely and comprehensive analysis by clinicians difficult but are ideal for automatic processing by machine learning algorithms. Early prediction of respiratory system failure could alert clinicians to patients at risk of respiratory failure and allow for early patient reassessment and treatment adjustment. We propose an early warning system that predicts moderate/severe respiratory failure up to 8 hours in advance. Our system was trained on HiRID-II, a data-set containing more than 60,000 admissions to a tertiary care ICU. An alarm is typically triggered several hours before the beginning of respiratory failure. Our system outperforms a clinical baseline mimicking traditional clinical decision-making based on pulse-oximetric oxygen saturation and the fraction of inspired oxygen. To provide model introspection and diagnostics, we developed an easy-to-use web browser-based system to explore model input data and predictions visually.

[1]  Arthur S Slutsky,et al.  Acute Respiratory Distress Syndrome The Berlin Definition , 2012 .

[2]  Alistair E. W. Johnson,et al.  The eICU Collaborative Research Database, a freely available multi-center database for critical care research , 2018, Scientific Data.

[3]  R. Ellis Determination of PO2 from saturation. , 1989, Journal of applied physiology.

[4]  Karsten M. Borgwardt,et al.  Early prediction of circulatory failure in the intensive care unit using machine learning , 2020, Nature Medicine.

[5]  Scott M. Lundberg,et al.  Consistent feature attribution for tree ensembles , 2017, ArXiv.

[6]  Top 10 technology hazards for 2012. The risks that should be at the top of your prevention list. , 2011, Health devices.

[7]  Xi Zhu,et al.  Predictive model for acute respiratory distress syndrome events in ICU patients in China using machine learning algorithms: a secondary analysis of a cohort study , 2019, Journal of Translational Medicine.

[8]  Hyuk-Jae Chang,et al.  Predicting Cardiac Arrest and Respiratory Failure Using Feasible Artificial Intelligence with Simple Trajectories of Patient Data , 2019, Journal of clinical medicine.

[9]  Peter Szolovits,et al.  MIMIC-III, a freely accessible critical care database , 2016, Scientific Data.

[10]  Tie-Yan Liu,et al.  LightGBM: A Highly Efficient Gradient Boosting Decision Tree , 2017, NIPS.

[11]  J. Severinghaus Simple, accurate equations for human blood O2 dissociation computations. , 1979, Journal of applied physiology: respiratory, environmental and exercise physiology.

[12]  M. Lamy,et al.  The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. , 1994, American journal of respiratory and critical care medicine.