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Prediction of blood pressure changes associated with abdominal pressure changes during robotic laparoscopic low abdominal surgery using deep learningopen access

Authors
Chung, Yang-HoonJeong, Young-SeobMartin, Gati LotherChoi, Min SeoKang, You JinLee, MisoonCho, AnaKoo, Bon SungCho, Sung HwanKim, Sang Hyun
Issue Date
Sep-2022
Publisher
Public Library of Science
Citation
PLoS ONE, v.17, no.6, pp 1 - 12
Pages
12
Journal Title
PLoS ONE
Volume
17
Number
6
Start Page
1
End Page
12
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21496
DOI
10.1371/journal.pone.0269468
ISSN
1932-6203
Abstract
Background Intraoperative hypertension and blood pressure (BP) fluctuation are known to be associated with negative patient outcomes. During robotic lower abdominal surgery, the patient's abdominal cavity is filled with CO2, and the patient's head is steeply positioned toward the floor (Trendelenburg position). Pneumoperitoneum and the Trendelenburg position together with physiological alterations during anesthesia, interfere with predicting BP changes. Recently, deep learning using recurrent neural networks (RNN) was shown to be effective in predicting intraoperative BP. A model for predicting BP rise was designed using RNN under special scenarios during robotic laparoscopic surgery and its accuracy was tested. Methods Databases that included adult patients (over 19 years old) undergoing low abdominal da Vinci robotic surgery (ovarian cystectomy, hysterectomy, myomectomy, prostatectomy, and salpingo-oophorectomy) at Soonchunhyang University Bucheon Hospital from October 2018 to March 2021 were used. An RNN-based model was designed using Python3 language with the PyTorch packages. The model was trained to predict whether hypertension (20% increase in the mean BP from baseline) would develop within 10 minutes after pneumoperitoneum. Results Eight distinct datasets were generated and the predictive power was compared. The macroaverage F1 scores of the datasets ranged from 68.18% to 72.33%. It took only 3.472 milliseconds to obtain 39 prediction outputs. Conclusions A prediction model using the RNN may predict BP rises during robotic laparoscopic surgery.
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