Automatic Selector Between Cardiogenic Oscillation and Airway Secretion in Mechanical Ventilation Flow Signals Using Artificial Immune System

Automatic Selector Between Cardiogenic Oscillation and Airway Secretion in Mechanical Ventilation Flow Signals Using Artificial Immune System

Samuel Sobral dos Santos (University of Pernambuco, Recife, Brazil), Hatus Vianna Wanderley (Bionica, Recife, Brazil) and Fernando Buarque de Lima Neto (University of Pernambuco, Recife, Brazil)
Copyright: © 2018 |Pages: 14
DOI: 10.4018/IJSIR.2018100104

Abstract

The accumulation of secretions in the airways of ventilator-dependent patients is a common problem, and if not detected and treated in due time, it greatly increases the risk of infections and asynchrony. Unfortunately, cardiogenic oscillation modifies the flow signal shape that can confuse clinical staff and modern lung ventilators. In this article, the authors use an artificial immune system algorithm in a pre-processed flow signal. The authors' approach was able to automatically detect the presence or absence of airway secretions, even if the sample contains the influence of cardiogenic oscillation. The training and validation of the algorithm was carried out using a database containing flow signals of 457 respiratory cycles, obtained from three patients in different ventilation modes. The algorithm trained with 60% of the base cycles, was able to achieve specificity and sensitivity above 0.96 in the classification of the remaining cycles of the base.
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Background

Mechanical Ventilation

(Gamsu, Singer, Vincent, Berry, & Nadel, 1976) Mechanical Ventilation (MV) is applied in situations where the patient’s spontaneous respiratory cycles are non-existent or insufficient. They are usually patients unconscious or afflicted by serious diseases in the respiratory system. The application of MV may be invasive, when the patient is connected to the ventilator through an endotracheal tube, or non-invasive, in which case the patient is connected to the ventilator by means of a face mask. Mechanical ventilation is indispensable in an intensive care unit, however, it can cause some important complications for the patient, so ventilators should be frequently monitored by qualified professionals in order to reduce ventilator errors and minimize risks. The accumulation of secretion in the airways is one of the problems that should be avoided. The presence of airway secretion in ventilator-dependent patients commonly leads to atelectasis or pneumonia (Gamsu et al., 1976). But there are other phenomena that could confuse the patient’s clinical evaluation. Among them is Cardiogenic Oscillation (CO), which are low-frequency modulation of basal flow signal produced by heartbeats (Tusman et al., 2009). Both situations may induce errors in the activation of ventilator cycles causing asynchronies such as self-triggering. And the last one can either delay the brain death diagnosis, increasing treatment costs and risk loss of donor organs (Arbour, 2009).

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