Artificial intelligence is to be trialled in a London hospital to help doctors spot intensive care patients at risk of delirium.
Ventilated Covid-19 patients who have required intubation are more likely than other ICU patients to suffer delirium, or acute confusion, when they are woken up and have their breathing tube removed.
This can cause serious problems during their recovery when they are likely to be fitted with a tracheostomy — breathing support via the neck and windpipe rather than the tube through the mouth — and are at risk of pulling it out.
The trial, at Chelsea and Westminster Hospital, will involve a camera being trained on a patient’s eyes to analyse their eye movement 60 times a second. Algorithms will compare the data to how often a patient would “normally” open and move their eyes.
Doctors will be alerted if a patient’s eye movements indicate they are becoming delirious. This also removes the need for “laborious” bedside tests, which can endanger clinicians if the patient is Covid-positive.
The trial, supported by the trust’s charity CW+, is being led by Dr Ahmed Al-Hindawi, an intensive care registrar. He said it could be in place for a feared second wave of Covid patients and to help patients admitted to ICU for other conditions.
The high number of patients becoming delirious with Covid had enabled him to fast-track the study.
Dr Al-Hindawi said the “majority” of Covid patients who required admission to intensive care at Chelsea and Westminster had developed delirium.
The environment, the disease and drugs make a concoction that really confuses people
“Because they have had such a large insult to their body, it plays on the mind,” he said. “Then they wake up in an environment they don’t recognise. The environment, the disease and the drugs make a concoction that really causes people to be confused.”
Latest England-wide data shows that almost 46 per cent of coronavirus patients who required ICU have died. More than 2,500 Covid-19 patients have been admitted to ICU in London, and about 11,300 nationwide.
Chelsea and Westminster is thought to have one of the lowest mortality rates, at about 20-25 per cent. By last week, 16 of the 70 patients it had admitted to ICU had died. Of the 54 survivors, about 25 had suffered delirium.
Delirious patients have an increased rate of mortality, stay longer in hospital and are more likely to suffer long-term cognitive impairment.
The number of Covid patients in London hospitals fell to 1,315 on Saturday, Downing Street announced yesterday. This is about a third of the peak of more than a month ago.
