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Detection of Needle Dislodgement Using Extracorporeal Pressure Signals : A Feasibility Study

Holmer, Mattias LU ; Olde, Bo ; Sandberg, Frida LU and Sörnmo, Leif LU (2020) In ASAIO Journal 66(4). p.454-462
Abstract

Venous needle dislodgement (VND) during dialysis is a rarely occurring adverse event, which becomes life-threatening if not handled promptly. Because the standard venous pressure alarm, implemented in most dialysis machines, has low sensitivity, a novel approach using extracted cardiac information to detect needle dislodgement is proposed. Four features are extracted from the arterial and venous pressure signals of the dialysis machine, characterizing the mean venous pressure, the venous cardiac pulse pressure, the time delay, and the correlation between the two pressure signals. The features serve as input to a support vector machine (SVM), which determines whether dislodgement has occurred. The SVM is first trained on a set of... (More)

Venous needle dislodgement (VND) during dialysis is a rarely occurring adverse event, which becomes life-threatening if not handled promptly. Because the standard venous pressure alarm, implemented in most dialysis machines, has low sensitivity, a novel approach using extracted cardiac information to detect needle dislodgement is proposed. Four features are extracted from the arterial and venous pressure signals of the dialysis machine, characterizing the mean venous pressure, the venous cardiac pulse pressure, the time delay, and the correlation between the two pressure signals. The features serve as input to a support vector machine (SVM), which determines whether dislodgement has occurred. The SVM is first trained on a set of laboratory data, and then tested on another set of laboratory data as well as on a small data set from clinical hemodialysis sessions. The results show that dislodgement can be detected after 12-17 s, corresponding to 24-143 ml blood loss. The standard venous pressure alarm used in clinical routine only detects 50% of the VNDs, whereas the novel method detects all VNDs and has a false alarm rate of 0.12 per hour, provided that the amplitude of the extracted cardiac pressure signal exceeds 1 mmHg. The results are promising; however, the method needs to be tested on a larger set of clinical data to better establish its performance.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
ASAIO Journal
volume
66
issue
4
pages
9 pages
publisher
Amercian Society of Artificial Internal Organs
external identifiers
  • pmid:31246584
  • scopus:85082562057
ISSN
1538-943X
DOI
10.1097/MAT.0000000000001020
language
English
LU publication?
yes
id
f986f328-c075-4ea8-9d36-43bd0c67d3af
date added to LUP
2020-04-16 17:15:16
date last changed
2022-05-02 08:20:53
@article{f986f328-c075-4ea8-9d36-43bd0c67d3af,
  abstract     = {{<p>Venous needle dislodgement (VND) during dialysis is a rarely occurring adverse event, which becomes life-threatening if not handled promptly. Because the standard venous pressure alarm, implemented in most dialysis machines, has low sensitivity, a novel approach using extracted cardiac information to detect needle dislodgement is proposed. Four features are extracted from the arterial and venous pressure signals of the dialysis machine, characterizing the mean venous pressure, the venous cardiac pulse pressure, the time delay, and the correlation between the two pressure signals. The features serve as input to a support vector machine (SVM), which determines whether dislodgement has occurred. The SVM is first trained on a set of laboratory data, and then tested on another set of laboratory data as well as on a small data set from clinical hemodialysis sessions. The results show that dislodgement can be detected after 12-17 s, corresponding to 24-143 ml blood loss. The standard venous pressure alarm used in clinical routine only detects 50% of the VNDs, whereas the novel method detects all VNDs and has a false alarm rate of 0.12 per hour, provided that the amplitude of the extracted cardiac pressure signal exceeds 1 mmHg. The results are promising; however, the method needs to be tested on a larger set of clinical data to better establish its performance.</p>}},
  author       = {{Holmer, Mattias and Olde, Bo and Sandberg, Frida and Sörnmo, Leif}},
  issn         = {{1538-943X}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{454--462}},
  publisher    = {{Amercian Society of Artificial Internal Organs}},
  series       = {{ASAIO Journal}},
  title        = {{Detection of Needle Dislodgement Using Extracorporeal Pressure Signals : A Feasibility Study}},
  url          = {{http://dx.doi.org/10.1097/MAT.0000000000001020}},
  doi          = {{10.1097/MAT.0000000000001020}},
  volume       = {{66}},
  year         = {{2020}},
}