Reducing False Intracranial Pressure Alarms using Morphological Waveform Features.

Abstract

False alarms produced by patient monitoring systems in intensive care units (ICU) are a major issue that causes alarm fatigue, waste of human resources, and increased patient risks. While alarms are typically triggered by manually adjusted thresholds, the trend and patterns observed prior to threshold crossing are generally not used by current systems. This study introduces and evaluates a smart alarm detection system for intracranial pressure signal (ICP) that is based on advanced pattern recognition methods. Models are trained in a supervised fashion from a comprehensive dataset of 4791 manually labelled alarm episodes extracted from 108 neurosurgical patients. The comparative analysis provided between spectral regression, kernel spectral regression, and support vector machines indicates the significant improvement of the proposed framework in detecting false ICP alarms in comparison to a threshold-based technique that is conventionally used. Another contribution of this work is to exploit an adaptive discretization to reduce the dimensionality of the input features. The resulting features lead to a decrease of 30% of false ICP alarms without compromising sensitivity.