Identification of patients with overt cardiorespiratory insufficiency or at high risk of impending cardiorespiratory insufficiency is often difficult outside the venue of directly observed patients in highly staffed areas of the hospital, such as the operating room, intensive care unit (ICU) or emergency department. And even in these care locations, identification of cardiorespiratory insufficiency early or predicting its development beforehand is often challenging. The clinical literature has historically prized early recognition of cardiorespiratory insufficiency and its prompt correction as being valuable at minimizing patient morbidity and mortality while simultaneously reducing healthcare costs. Recent data support the statement that integrated monitoring systems that create derived fused parameters of stability or instability using machine learning algorithms, accurately identify cardiorespiratory insufficiency and can predict their occurrence. In this overview, we describe integrated monitoring systems based on established machine learning analysis using various established tools, including artificial neural networks, k?nearest neighbor, support vector machine, random forest classifier and others on routinely acquired non?invasive and invasive hemodynamic measures to identify cardiorespiratory insufficiency and display them in real?time with a high degree of precision.

We review the problem of time-critical action and discuss a reformulation that shifts knowledge acquisition from the assessment of complex temporal probabilistic dependencies to the direct assessment of time-dependent utilities over key outcomes of interest. We dwell on a class of decision problems characterized by the centrality of diagnosing and reacting in a timely manner to pathological processes. We motivate key ideas in the context of trauma-care triage and transportation decisions.