Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients
Name
Gu_EMBC2019_final.pdf
Description
Accepted version
Size
729.02 KB
Format
Adobe PDF
Checksum (MD5)
94beebc095e7e57e130bd2c9683e1be2
Author(s)
Gu, Qiao
Prasad, Varesh
Heldt, Thomas
Date Issued
October 2019
Journal
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Publisher
Institute of Electrical and Electronics Engineers (IEEE)
Citation
Gu, Qiao et al. "Characterizing Fluid Response and Sepsis Progression in Emergency Department Patients." Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, July 2019, Berlin Germany, Institute of Electrical and Electronics Engineers, October 2019. © 2019 IEEE
Version
Author's final manuscript
Abstract
Sepsis and septic shock are major global public health concerns. The main therapies for sepsis-related hypotension are fluid resuscitation and vasopressor therapy, though it can be challenging to determine the amount of fluid that should be given or the optimal timing to transition to vasopressor administration. To characterize patients' response to fluid bolus therapy (FBT) and analyze the sepsis progress using multiple vital signs, we mined a database containing 761 patients presenting to the Emergency Department (ED) with vital signs and laboratory values indicating high risk of septic shock. By clustering the patients' mean arterial pressure (MAP) time series during a time window around FBT, we found that clusters showing fluid responsiveness during the two hours after FBT only included about 25% of studied boluses. In addition, MAP responses tended to vary based on the initial MAP level. We also found that the trajectories of heart rate and MAP in a 2-D plane demonstrated general trends related to the hemodynamic progression of sepsis and previously described phases of septic shock. Potentially compensatory and decompensatory responses of the cardiovascular system to the insults of sepsis were reflected in the clusters representative of different phases.
MIT Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science
Harvard University--MIT Division of Health Sciences and Technology
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
Terms of Use
Creative Commons Attribution-Noncommercial-Share Alike
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1109/embc.2019.8856521
