Automated Assessment of Cardiovascular Sufficiency Using Non-Invasive Physiological Data

Abstract

For fluid resuscitation of critically ill individuals to be effective, it must be well calibrated in terms of timing and dosages of treatments. In current practice, the cardiovascular sufficiency of patients during fluid resuscitation is determined using primarily invasively measured vital signs, including Arterial Pressure and Mixed Venous Oxygen Saturation (SvO2), which may not be available in outside-of-hospital settings, particularly in the field when treating subjects injured in traffic accidents or wounded in combat where only non-invasive monitoring is available to drive care. In this paper, we propose (1) a Machine Learning (ML) approach to estimate the sufficiency utilizing features extracted from non-invasive vital signs and (2) a novel framework to address the detrimental impact of inter-patient diversity on the ability of ML models to generalize well to unseen subjects. Through comprehensive evaluation on the physiological data collected in laboratory animal experiments, we demonstrate that the proposed approaches can achieve competitive performance on new patients using only non-invasive measurements. These characteristics enable effective monitoring of fluid resuscitation in real-world acute settings with limited monitoring resources and can help facilitate broader adoption of ML in this important subfield of healthcare.