Imitating the respiratory activity of the brain stem by using artificial neural networks: exploratory study on an animal model of lactic acidosis and proof of concept.

Journal: Journal of clinical monitoring and computing
PMID:

Abstract

Artificial neural networks (ANNs) are versatile tools capable of learning without prior knowledge. This study aims to evaluate whether ANN can calculate minute volume during spontaneous breathing after being trained using data from an animal model of metabolic acidosis. Data was collected from ten anesthetized, spontaneously breathing pigs divided randomly into two groups, one without dead space and the other with dead space at the beginning of the experiment. Each group underwent two equal sequences of pH lowering with pre-defined targets by continuous infusion of lactic acid. The inputs to ANNs were pH, ΔPaCO (variation of the arterial partial pressure of CO), PaO, and blood temperature which were sampled from the animal model. The output was the delta minute volume (ΔV), (the change of minute volume as compared to the minute volume the animal had at the beginning of the experiment). The ANN performance was analyzed using mean squared error (MSE), linear regression, and the Bland-Altman (B-A) method. The animal experiment provided the necessary data to train the ANN. The best architecture of ANN had 17 intermediate neurons; the best performance of the finally trained ANN had a linear regression with R of 0.99, an MSE of 0.001 [L/min], a B-A analysis with bias ± standard deviation of 0.006 ± 0.039 [L/min]. ANNs can accurately estimate ΔV using the same information that arrives at the respiratory centers. This performance makes them a promising component for the future development of closed-loop artificial ventilators.

Authors

  • Gaetano Perchiazzi
    Department of Emergency and Organ Transplant, Section of Anaesthesia and Intensive Care Medicine, University of Bari, c/o Centro di Rianimazione - Policlinico Hospital, Piazza Giulio Cesare, 11, 70124, Bari, Italy. gaetano.perchiazzi@uniba.it.
  • Rafael Kawati
    Department of Anesthesia, Operation and Intensive Care, Uppsala University Hospital, Uppsala, Sweden.
  • Mariangela Pellegrini
    Department of Emergency and Organ Transplant, Section of Anaesthesia and Intensive Care Medicine, University of Bari, c/o Centro di Rianimazione - Policlinico Hospital, Piazza Giulio Cesare, 11, 70124, Bari, Italy.
  • Jasmine Liangpansakul
    The Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
  • Roberto Colella
    Ministry of Education and Merit, Rome, Italy.
  • Paolo Bollella
    Department of Chemistry, University of Bari Aldo Moro, Bari, Italy.
  • Pramod Rangaiah
    Department of Electrical Engineering, Solid-State Electronics, Uppsala University, Uppsala, Sweden.
  • Annamaria Cannone
    Department of Anaesthesia and Intensive Care, "Madonna delle Grazie" Hospital, Matera, Italy.
  • Deepthi Hulithala Venkataramana
    Department of Information Technology, Uppsala University, Uppsala, Sweden.
  • Mauricio Perez
    Institute of Computing, University of Campinas, Brazil.
  • Sebastiano Stramaglia
    Dipartimento Interateneo di Fisica, University of Bari, Italy; INFN Sezione di Bari, Italy.
  • Luisa Torsi
    Department of Chemistry, University of Bari Aldo Moro, Bari, Italy.
  • Roberto Bellotti
    Dipartimento Interateneo di Fisica "M. Merlin", Università degli studi di Bari "A. Moro", Bari, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Bari, Italy. Electronic address: roberto.bellotti@uniba.it.
  • Robin Augustine
    Department of Electrical Engineering, Solid-State Electronics, Uppsala University, Uppsala, Sweden.