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February 8, 2026BioMedical Engineering OnLine0 citationsOpen Access

Removal of cardiogenic oscillations during pressure support ventilation using sliding window singular spectrum analysis: proof-of-concept

PPParwane P. PaganoECEdward J. Ciaccio

Key Result

Sliding-window SSA reduced cardiogenic oscillations in airflow signals by 82-87% while preserving respiratory waveform with correlation of 0.92-0.94 in adult intubated surgical patients during pressure support ventilation.

Key Points

  • The aim is to explore the effectiveness of sliding-window singular spectrum analysis in reducing cardiogenic oscillations during pressure support ventilation.
  • Applied sliding-window singular spectrum analysis to patient airflow signals
  • Compared oscillation levels before and after analysis
  • Tested integration with autotrigger-suppression logic
  • Significant attenuation of cardiogenic oscillations observed
  • Dominant respiratory pattern preserved
  • Potential for clinical implementation noted, pending further validation

Study Design

Type

Observational (n=2)

Multicenter

No

Structured PICO

Does sliding-window singular spectrum analysis attenuate cardiogenic oscillations in airflow signals of intubated patients on pressure support ventilation?

P
Population
2 adult patients undergoing non-cardiac surgery under general anesthesia with an endotracheal tube, receiving pressure support ventilation.
I
Intervention
Sliding-window singular spectrum analysis (SSA) applied to high-resolution airflow and ECG signals (6-second sliding window, 12-second initialization).
C
Comparator
Original unadjusted airflow signal.
O
Outcome
Attenuation of cardiogenic oscillations (measured by reduction in cardiac-frequency spectral power) and waveform fidelity (correlation with respiratory envelope and root-mean-square error).surrogate

Sliding-window singular spectrum analysis effectively filters cardiogenic oscillations from airflow signals in real-time, offering a potential software solution to prevent ventilator autotriggering.

Main Result

Effect estimate: 82-87% reduction in cardiac-frequency spectral power

Limitations

  • Very small sample size (2 patients) limits generalizability
  • Only observational data analyzed, no randomization or control group
  • Algorithm tested offline on recorded data, not implemented in actual ventilators
  • Possible smoothing artifacts introduced by SSA affecting subtle respiratory waveform features
  • Patient population limited to adult non-cardiac surgery patients under general anesthesia
  • No assessment in patients with arrhythmias or diverse pulmonary mechanics
  • Small sample size
  • SSA inevitably introduces smoothing, which can distort physiological details
  • Did not implement the algorithm in actual ventilators

Abstract

Sliding-window SSA attenuated cardiogenic oscillations in patient airflow signals and preserved the dominant respiratory pattern. As a proof-of-concept, this approach shows potential for integration into autotrigger-suppression logic, though further validation in larger and more diverse populations is required.

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Cite This Study

Pagano et al. (2026) conducted an observational in Adult intubated patients under general anesthesia receiving pressure support ventilation during non-cardiac surgery (n=2). Sliding-window singular spectrum analysis (SSA) applied to airflow signals vs. Original raw airflow signals without SSA filtering was evaluated on Attenuation of cardiogenic oscillations assessed by reduction in cardiac-frequency spectral power and preservation of respiratory waveform morphology (82-87% reduction in cardiac-frequency spectral power). Sliding-window SSA reduced cardiogenic oscillations in airflow signals by 82-87% while preserving respiratory waveform with correlation of 0.92-0.94 in adult intubated surgical patients during pressure support ventilation.

synapsesocial.com/papers/698828850fc35cd7a88481d9https://doi.org/10.1186/s12938-026-01536-3
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