Prediction of the central venous pressure in trauma patients on the basis of non-invasive parameters using artificial neural network

Background: Generally, in traumatic patients, uncontrolled bleeding leads to shock and ultimately death. So, any early detection of shock can reduce the likelihood of a patient's death. At present, the precise method for estimating the body's need for fluids is to measure central venous pressure (CVP). However, this method is invasive and time consuming. Objective: This study aimed to predict the central venous pressure value and range of trauma patients through non-invasive parameters such as caval index, lactate clearance, base excess and shock index. Methods: A prospective observational study was performed in 100 trauma patients. Written informed consent was obtained from patient(s) or relatives for their anonymized information to be published in any article. Results: It indicated that parameters such as caval index (at a proposed cutoff point of 35%), lactate clearance (at a cutoff point of 6%) and base excess (at a proposed cutoff point of 6 mmol/L) are approximately of the same level of accuracy for estimating the central venous pressure range, while parameter shock index (at a cutoff point of 1.25) is of the least level of accuracy to predict the central venous pressure range. Results also showed that among all proposed predictive models for estimating the central venous pressure value, which were on the basis of either non-linear regression or artificial neural network, the most accurate model was the one on the basis of the artificial neural network. Among parameters lactate clearance, base excess and shock index used to form the artificial neural network-based model, parameters base excess and lactate clearance were of the highest and lowest level of importance, respectively. Conclusion: Among all proposed models and non-invasive parameters to predict the central venous pressure range, CVPLC model (at a cutoff point of 9), which is a non-linear regression model and is in terms of parameter lactate clearance, was the most accurate model.