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Institute of Electrical and Electronics Engineers, IEEE Transactions on Biomedical Engineering, 7(56), p. 1849-1863, 2009

DOI: 10.1109/tbme.2009.2018295

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A Multichannel Model-Based Methodology for Extubation Readiness Decision of Patients on Weaning Trials

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This paper is available in a repository.

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Abstract

Discontinuation of mechanical ventilation is a challenging task that involves a number of subtle clinical issues. The gradual removal of the respiratory support (referred to as weaning ) should be performed as soon as autonomous respiration can be sustained. However, the prediction rate of successful extubation is still below 25% based on previous studies. Construction of an automatic system that provides information on extubation readiness is thus desirable. Recent works have demonstrated that the breathing pattern variability is a useful extubation readiness indicator, with improving performance when multiple respiratory signals are jointly processed. However, the existing methods for predictor extraction present several drawbacks when length-limited time series are to be processed in heterogeneous groups of patients. In this paper, we propose a model-based methodology for automatic readiness prediction. It is intended to deal with multichannel, nonstationary, short records of the breathing pattern. Results on experimental data yield an 87.27% of successful readiness prediction, which is in line with the best figures reported in the literature. A comparative analysis shows that our methodology overcomes the shortcomings of so far proposed methods when applied to length-limited records on heterogeneous groups of patients.