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This paper investigates the feasibility of detecting and estimating the rate of internal hemorrhage based on continuous noninvasive hematocrit measurement. A unique challenge in hematocrit-based hemorrhage detection is that hematocrit decreases in response to hemorrhage and resuscitation with fluids, which makes hemorrhage detection during resuscitation challenging. We developed two sequential inference algorithms for detection of internal hemorrhage based on the Luenberger observer and the extended Kalman filter. The sequential inference algorithms use fluid resuscitation dose and hematocrit measurement as inputs to generate signatures to enable detection of internal hemorrhage. In the case of the extended Kalman filter, the signature is nothing but inferred hemorrhage rate, which allows it to also estimate internal hemorrhage rate. We evaluated the proof-of-concept of these algorithms based on in silico evaluation in 100 virtual patients subject to diverse hemorrhage and resuscitation rates. The results showed that the sequential inference algorithms outperformed naïve internal hemorrhage detection based on the decrease in hematocrit when hematocrit noise level was 1% (average F1 score: Luenberger observer 0.80; extended Kalman filter 0.76; hematocrit 0.59). Relative to the Luenberger observer, the extended Kalman filter demonstrated comparable internal hemorrhage detection performance and superior accuracy in estimating the hemorrhage rate. The analysis of the dependence of the sequential inference algorithms on measurement noise and plant parametric uncertainty showed that small (≤1%) hematocrit noise level and personalization of sequential inference algorithms may enable continuous noninvasive detection of internal hemorrhage and estimation of its rate.
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Robust Nonlinear State Space Model Identification for Hemorrhage Resuscitation
This paper presents a novel method for predicting hemodynamic responses in hemorrhage resuscitation. The proposed approach, namely, robust nonlinear state space modeling (RNSSM), aims to overcome challenges of identifying reliable models using limited and noisy critical care data by innovatively integrating autoencoder learning and variational Gaussian inference in a unified framework. Simulation results demonstrate the initial feasibility and performance evidence of the RNSSM approach as a digital twin of an animal study in hemorrhage resuscitation scenarios.
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- Award ID(s):
- 2138929
- PAR ID:
- 10510734
- Publisher / Repository:
- IEEE
- Date Published:
- ISBN:
- 979-8-3503-1050-4
- Page Range / eLocation ID:
- 1 to 4
- Format(s):
- Medium: X
- Location:
- Pittsburgh, PA, USA
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.1109/BHI58575.2023.10313391
