Improving Mechanical Ventilator Clinical Decision Support Systems with A Machine Learning Classifier for Determining Ventilator Mode

Clinical decision support systems (CDSS) will play an in-creasing role in improving the quality of medical care for critically ill patients. However, due to limitations in current informatics infrastructure, CDSS do not always have com-plete information on state of supporting physiologic monitor-ing devices, which can limit the input data available to CDSS. This is especially true in the use case of mechanical ventilation (MV), where current CDSS have no knowledge of critical ventilation settings, such as ventilation mode. To enable MV CDSS to make accurate recommendations related to ventilator mode, we developed a highly performant ma-chine learning model that is able to perform per-breath clas-sification of 5 of the most widely used ventilation modes in the USA with an average F1-score of 97.52%. We also show how our approach makes methodologic improvements over previous work and that it is highly robust to missing data caused by software/sensor error.