Detection of patient-ventilator asynchrony from mechanical ventilation waveforms using a two-layer long short-term memory neural network

• Published in: Computers in biology and medicine Vol. 120; p. 103721
• Main Authors: Zhang, Lingwei, Mao, Kedong, Duan, Kailiang, Fang, Siqi, Lu, Yunfei, Gong, Qiang, Lu, Fei, Jiang, Ye, Jiang, Liuqing, Fang, Wenyao, Zhou, Xiaolin, Wang, Jimei, Fang, Luping, Ge, Huiqing, Pan, Qing
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.05.2020; Elsevier Limited
• Subjects: Algorithms; Anesthesia; Annotations; Blood pressure; Datasets; Deep learning; Information systems; Learning algorithms; Long short-term memory; Long short-term memory network; Machine learning; Mechanical ventilation; Neural networks; Neuromuscular diseases; Oxygen saturation; Patient-ventilator asynchrony; Patients; Respiration; Ventilation; Ventilators; Waveforms; Deep learning; Long short-term memory network; Mechanical ventilation; Patient-ventilator asynchrony; Machine learning
• ISSN: 0010-4825; 1879-0534
• DOI: 10.1016/j.compbiomed.2020.103721

Mismatch between invasive mechanical ventilation and the requirements of patients results in patient-ventilator asynchrony (PVA), which is associated with a series of adverse clinical outcomes. Although the efficiency of the available approaches for automatically detecting various types of PVA from the ventilator waveforms is unsatisfactory, the feasibility of powerful deep learning approaches in addressing this problem has not been investigated. We propose a 2-layer long short-term memory (LSTM) network to detect two most frequently encountered types of PVA, namely, double triggering (DT) and ineffective inspiratory effort during expiration (IEE), on two datasets. The performance of the networks is evaluated first using cross-validation on the combined dataset, and then using a cross testing scheme, in which the LSTM networks are established on one dataset and tested on the other. Compared with the reported rule-based algorithms and the machine learning models, the proposed 2-layer LSTM network exhibits the best overall performance, with the F1 scores of 0.983 and 0.979 for DT and IEE detection, respectively, on the combined dataset. Furthermore, it outperforms the other approaches in cross testing. The findings suggest that LSTM is an excellent technique for accurate recognition of PVA in clinics. Such a technique can help detect and correct PVA for a better patient ventilator interaction.