Image: An AI tool helps determine when critically ill patients can breathe on their own (Photo Courtesy of The Ottawa Hospital)
In the past two years of the pandemic, more people than ever have experienced extreme breathing difficulties, requiring mechanical ventilation (intubation) in intensive care units around the world. A mechanical ventilator is a machine that helps patients breathe when they are unable to breathe on their own due to a critical illness, such as COVID-19 or surgery. The machine is connected to a breathing tube that is inserted into the patient’s windpipe. The process of intubating (inserting the tube) and extubating (removing the tube) is very complex, and anyone who needs a ventilator needs months of recovery and rehabilitation to learn to swallow, eat, talk and breathe again. Currently, there is no patient monitoring equipment to help doctors decide the best time to remove a patient from a ventilator to improve their outcomes, but that may be about to change.
Ottawa Hospital (Ontario, Canada) is the world’s first hospital to evaluate an innovative medical device that uses artificial intelligence (AI) to predict when critically ill patients will be ready to breathe on their own. Over the past 13 years, the team developing the device has made great strides in using complex math, AI, and routinely collected vital sign data to predict when patients will be ready to be extubated. The device, called the Extubation Advisor, continuously monitors and analyzes a patient’s vital signs, including blood pressure, oxygen levels, breathing rhythms, and heart rate during their ventilation. It then uses AI to give doctors a specific reading of when the patient can be safely removed from the ventilator.
This is the first time real-time predictive analytics based on this type of high-frequency data have been used and evaluated at the bedside. The system was used at the bedside of ventilated patients in Ottawa Hospital’s Intensive Care Unit (ICU) for three months, with the consent of their families. After the successful first evaluation, the statistics look promising and the feedback from doctors has been very positive. The team hopes the device will help improve patient safety and outcomes in the near future. The team’s next steps include a randomized controlled trial. With each milestone, they are one step closer to transforming care for some of the sickest patients treated in hospitals.
“Currently, one in seven ICU patients experiences extubation failure. Long-term ventilation harms patients, and early extubation requiring re-intubation can be a devastating blow to their recovery,” said Dr. Andrew Seely, an intensive care physician, thoracic surgeon and scientist at The Ottawa Hospital, who developed the device. “We have developed the first medical device to support extubation taking, which we believe will help standardize and improve care.”
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The Ottawa Hospital