Causal Structure of Brain Physiology after Brain Injury from Subarachnoid Hemorrhage

PLoS One. 2016 Apr 28;11(4):e0149878. doi: 10.1371/journal.pone.0149878. eCollection 2016.

Abstract

High frequency physiologic data are routinely generated for intensive care patients. While massive amounts of data make it difficult for clinicians to extract meaningful signals, these data could provide insight into the state of critically ill patients and guide interventions. We develop uniquely customized computational methods to uncover the causal structure within systemic and brain physiologic measures recorded in a neurological intensive care unit after subarachnoid hemorrhage. While the data have many missing values, poor signal-to-noise ratio, and are composed from a heterogeneous patient population, our advanced imputation and causal inference techniques enable physiologic models to be learned for individuals. Our analyses confirm that complex physiologic relationships including demand and supply of oxygen underlie brain oxygen measurements and that mechanisms for brain swelling early after injury may differ from those that develop in a delayed fashion. These inference methods will enable wider use of ICU data to understand patient physiology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Brain / physiopathology*
  • Brain Injuries / etiology*
  • Brain Injuries / physiopathology*
  • Critical Care
  • Critical Illness
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Nervous System Physiological Phenomena
  • Signal-To-Noise Ratio
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / physiopathology*