Detection of Needle Dislodgement Using Extracorporeal Pressure Signals: A Feasibility Study

Research output: Contribution to journalArticle

Abstract

Venous needle dislodgement (VND) during dialysis is a rarely occurring adverse event, which becomes life-threatening if not handled promptly. Because the standard venous pressure alarm, implemented in most dialysis machines, has low sensitivity, a novel approach using extracted cardiac information to detect needle dislodgement is proposed. Four features are extracted from the arterial and venous pressure signals of the dialysis machine, characterizing the mean venous pressure, the venous cardiac pulse pressure, the time delay, and the correlation between the two pressure signals. The features serve as input to a support vector machine (SVM), which determines whether dislodgement has occurred. The SVM is first trained on a set of laboratory data, and then tested on another set of laboratory data as well as on a small data set from clinical hemodialysis sessions. The results show that dislodgement can be detected after 12-17 s, corresponding to 24-143 ml blood loss. The standard venous pressure alarm used in clinical routine only detects 50% of the VNDs, whereas the novel method detects all VNDs and has a false alarm rate of 0.12 per hour, provided that the amplitude of the extracted cardiac pressure signal exceeds 1 mmHg. The results are promising; however, the method needs to be tested on a larger set of clinical data to better establish its performance.

Details

Authors
Organisations
External organisations
  • Baxter Medical AB
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Biomedical Laboratory Science/Technology
Original languageEnglish
Pages (from-to)454-462
Number of pages9
JournalASAIO journal (American Society for Artificial Internal Organs : 1992)
Volume66
Issue number4
Publication statusPublished - 2020 Apr
Publication categoryResearch
Peer-reviewedYes