Abstract
Hypotension is type of secondary insult and it is related to poor outcome. The ability to predict adverse hypotensive events, where a patient’s arterial blood pressure drops to abnormally low levels, would be of major benefit to the fields of primary and secondary health care. The aim of the paper is to present the novel method for predicting of acute hypotensive episodes, based on ECG analysis by the complex system theory approach. 45 patients (in four neurointensive care facilities throughout Europe) data were selected for the analysis. 11 patients had EUSIG-defined hypotensive events. The method includes determining of time varying biomarkers corresponding to plurality of physiological processes in patient’s organism as a non-linear dynamic complex system and generating an acute hypotension prediction classifier. The calculations of biomarkers are based on complex system approach and algebraic matrix analysis of ECG parameters. The classifier is based on the comparison of biomarkers behaviour in 3D images. It is demonstrated that the presented method allows us to predict arterial hypotension events 40-50 minutes ahead with a sensitivity of 81 %, specificity 94 %. This result was obtained from prospective real-time data collection in a live clinical intensive care environment.
Highlights
Patients being treated in an intensive care unit for traumatic brain injury are at risk of secondary insults [1], [2]
At first for each patient the arterial blood pressure was evaluated by Edinburgh University Secondary Insult Grading (EUSIG)-defined hypotensive events definition
The closer the patient gets to a hypotensive event the more and more chaotic the images become which is indicative of a system when the system is unstable
Summary
Patients being treated in an intensive care unit for traumatic brain injury are at risk of secondary insults [1], [2]. These insults can lead to further injury to the brain by potentiating pathological processes in the tissue. One of the most dangerous types of systemic secondary insults is hypotension, critically low arterial blood pressure. This research was performed by Health Telematics Science Institute at Kaunas University of Technology. Clinical data were collected in Institute of Cardiology of Lithuanian University of Health Sciences, Vilnius University Hospital Santariskiu Klinikos and Republican Vilnius University Hospital
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