A reinforcement learning approach to weaning of mechanical ventilation in intensive care units

Niranjani Prasad, Li Fang Cheng, Corey Chivers, Michael Draugelis, Barbara E. Engelhardt

Research output: Contribution to conferencePaper

17 Scopus citations

Abstract

The management of invasive mechanical ventilation, and the regulation of sedation and analgesia during ventilation, constitutes a major part of the care of patients admitted to intensive care units. Both prolonged dependence on mechanical ventilation and premature extubation are associated with increased risk of complications and higher hospital costs, but clinical opinion on the best protocol for weaning patients off of a ventilator varies. This work aims to develop a decision support tool that uses available patient information to predict time-to-extubation readiness and to recommend a personalized regime of sedation dosage and ventilator support. To this end, we use off-policy reinforcement learning algorithms to determine the best action at a given patient state from sub-optimal historical ICU data. We compare treatment policies from fitted Qiteration with extremely randomized trees and with feedforward neural networks, and demonstrate that the policies learnt show promise in recommending weaning protocols with improved outcomes, in terms of minimizing rates of reintubation and regulating physiological stability.

Original languageEnglish (US)
StatePublished - Jan 1 2017
Event33rd Conference on Uncertainty in Artificial Intelligence, UAI 2017 - Sydney, Australia
Duration: Aug 11 2017Aug 15 2017

Other

Other33rd Conference on Uncertainty in Artificial Intelligence, UAI 2017
CountryAustralia
CitySydney
Period8/11/178/15/17

All Science Journal Classification (ASJC) codes

  • Artificial Intelligence

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    Prasad, N., Cheng, L. F., Chivers, C., Draugelis, M., & Engelhardt, B. E. (2017). A reinforcement learning approach to weaning of mechanical ventilation in intensive care units. Paper presented at 33rd Conference on Uncertainty in Artificial Intelligence, UAI 2017, Sydney, Australia.