Deep learning approach for stroke volume variation estimation: retrospective modeling and prospective deployment in real-world practice

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Retrospective MAE = 0.70, Prospective MAE = 1.33

• Primary Outcome: Agreement between SVVNet and reference standard (ABP-PWA)

• Nnt Or Sensitivity: Retrospective correlation r = 0.92, Prospective correlation r = 0.87

• Confidence Interval: Not reported

Clinical Application

Demonstrated real-time deployment on tablet device in operating room Relevant for Australian perioperative practice; would require TGA approval for clinical use as medical device software Patients undergoing general anesthesia requiring hemodynamic monitoring

Abstract

Objective. We developed stroke volume variation (SVV) Net, a deep learning-based model for estimating SVV, and validated its performance and clinical applicability through both large-scale retrospective modeling and prospective real-time deployment within intraoperative settings.Approach. A SVVNet was trained on arterial blood pressure (ABP) waveforms from 2849 patients undergoing general anesthesia at Asan Medical Center (AMC). For retrospective validation, we utilized AMC cohorts and a publicly accessible database to assess agreement, trending ability, noise robustness (quantifies via signal quality index), and inter-individual deviation against ABP-based pulse wave analysis (ABP-PWA) and other DL models. For prospective validation, the optimized model was deployed onto a tablet and prospectively evaluated in real-time during 67 surgeries.Main results. In the retrospective external validation, SVVNet achieved higher agreement mean absolute error (MAE = 0.70, Pearsonρ= 0.92), compared to ABP-PWA algorithm (MAE = 1.30, Pearsonρ= 0.80) and lower inter-individual deviation. It was more robust to signal noise (MAE = 4.33 vs 30.87). In the prospective real-time deployment, our deployed model achieved an MAE of 1.33 and a Pearson correlation of 0.87 against the ground truth.Significance. This study emphasizes the advantages of the DL-based model compared to ABP-PWA-based algorithms and presents prospective results that support the clinical applicability of SVVNet in the operating room. Our model has the potential to replace pre-existing monitoring systems and to enhance the complex surgical environment.

References

1. 1.Shin, J. M., Seo, W. Y., Kim, W. J., Kim, C., Park, J., Kim, H. S., & Kim, S. H. (2026). Deep learning approach for stroke volume variation estimation: retrospective modeling and prospective deployment in real-world practice. Physiological Measurement. https://doi.org/10.1088/1361-6579/ae4cee