VYZR Care
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Predictive overview
latest obs 1m ago
Patient intelligence · showcase: infection-trajectory

K. Lindqvist · 48M

Bed 07 · AKI · hospital day 3 · Obstructive AKI after ureteric stone; stent placed day 1; febrile since.

Context: Gentamicin single dose day 1, then co-amoxiclav

VYZR Care RPP Engineconnecting…
Urgent · Rapidly worsening

Temperature 37.3 → 38.6 → 38.7 °C over 44h; heart rate 85 → 106 → 110 /min over 44h; respiratory rate 16 → 21 → 22 /min over 47h; white cells 11.2 → 14.8 → 18.1 ×10⁹/L over 45h; CRP 40 → 120 → 190 mg/L over 45h; lactate 1.2 → 1.9 mmol/L over 45h; systolic pressure 128 → 114 → 114 mmHg over 43h. Inflammatory markers are moving with a physiological response — the pattern is systemic, not just a lab value. Occurring despite current antibiotic therapy (recorded context). If the current slope continues: HR ≈ 133 (127–138 /min) at 24h, crossing HR 130/min in ~21h; Temp ≈ 39.5 (39.3–39.8 °C) at 12h; SBP ≈ 105 (99–112 mmHg) at 24h. 2 related patterns also active (multisystem deterioration, falling perfusion reserve).

Preparing narrative…
01 · Recognized · last 2 d
Urgent · Rapidly worsening

Systemic infection trajectory

Temperature 37.3 → 38.6 → 38.7 °C over 44h; heart rate 85 → 106 → 110 /min over 44h; respiratory rate 16 → 21 → 22 /min over 47h; white cells 11.2 → 14.8 → 18.1 ×10⁹/L over 45h; CRP 40 → 120 → 190 mg/L over 45h; lactate 1.2 → 1.9 mmol/L over 45h; systolic pressure 128 → 114 → 114 mmHg over 43h. Inflammatory markers are moving with a physiological response — the pattern is systemic, not just a lab value. Occurring despite current antibiotic therapy (recorded context).

Pattern strength75/100 · higher evidence

Experimental explainable index, not a probability. 7 of 8 expected signals available 57 measurements across supporting signals

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NOW−72h+24h
Measured · 12 points · last 4h agoProjected · shaded = uncertainty band

38.7 °C (+0.1 °C since previous), above range, stable · 5 consecutive falls.

Temperature

38.7 °C · stable · 5 consecutive falls

Heart rate

110 /min · rising · +27 /min/24h · 3 consecutive rises

Respiratory rate

22 /min · rising · +6 /min/24h · 5 consecutive rises

White cell count

18.1 ×10⁹/L · rising · +3.8 ×10⁹/L/24h · 2 consecutive rises

02 · Predicted
24hhigher evidence confidence

If the current slope continues: HR ≈ 133 (127–138 /min) at 24h, crossing HR 130/min in ~21h; Temp ≈ 39.5 (39.3–39.8 °C) at 12h; SBP ≈ 105 (99–112 mmHg) at 24h.

Next in line if this continues: Septic circulatory failure with hypoperfusion.

Higher evidence quality: several concordant, fresh, repeated measurements. Still a linear extrapolation, not a forecast of outcome.

Projections · 4 made · 0 withheld
Heart rateols-recent · fitted on 6 points · slope +0.94 /min/h
+6h · Sep 25 21:39
116 (111–120)
+12h · Sep 26 03:39
121 (116–126)
+24h · Sep 26 15:39
133 (127–138)

HR 130/min in ~21h if the current slope continues (at Sep 26 12:39).

Temperatureols-recent · fitted on 5 points · slope +0.05 °C/h
+6h · Sep 25 21:39
39.2 (39–39.5)
+12h · Sep 26 03:39
39.5 (39.3–39.8)
Systolic blood pressureols-recent · fitted on 7 points · slope -0.37 mmHg/h
+6h · Sep 25 21:39
112 (107–117)
+12h · Sep 26 03:39
110 (104–115)
+24h · Sep 26 15:39
105 (99–112)
C-reactive proteinols-recent · fitted on 3 points · slope +3.33 mg/L/h
+6h · Sep 25 21:39
213 (208–219)
+12h · Sep 26 03:39
233 (228–239)
+24h · Sep 26 15:39
273 (267–279)
Alternative explanations
  • · Post-operative or post-procedural inflammatory response without infection.
  • · Drug reaction or transfusion reaction causing fever and tachycardia.
  • · Thromboembolic disease (PE/DVT) producing fever, tachycardia and CRP rise.
  • · Dehydration-driven tachycardia coinciding with a lagging CRP.
04 · Consider now

Consider treatment failure or resistant organism, a second source, line/catheter infection, and non-infective mimics (drug fever, thrombosis).

The engine judges this pattern strong, fresh and fast enough to justify interrupting a clinician.

Decision support only · no order has been placed · engine rpp-0.4.0 · latest supporting value 1 min ago

03 · Connected

What may be causing what

Mechanistic chain assembled from the recognised features. Each link is a hypothesis for bedside verification, not an established cause.

Rising inflammatory markerscytokine-mediated vasodilationTachycardia → falling pressure
Systemic inflammationmitochondrial dysfunction / hypoperfusionRising lactate, organ dysfunction

Evidence · 23 raw observations

Timestamps are real and irregular · click an observation to focus its trace above
04 · Prevention prompts

Consider, investigate, monitor, escalate

Clinician-support prompts derived from the pattern — not prescriptions. Status is persisted so the team sees what has been planned or judged not appropriate.

Consider causes

Consider treatment failure or resistant organism, a second source, line/catheter infection, and non-infective mimics (drug fever, thrombosis).

Missing information

Culture results, source examination findings and device/line status are not in the structured record.

Investigate

Consider cultures before any antimicrobial change, lactate repeat, and source-directed imaging.

Monitor

Consider increasing observation frequency and tracking urine output while markers are rising.

Medication review

Review current antimicrobial spectrum, timing and renal dosing; review immunosuppressants.

Level of care

Consider senior review and local sepsis pathway if SBP falls below 100 mmHg, lactate rises above 2 mmol/L, or mentation changes.

Other active patterns · 2

Multisystem deterioration

Respiratory rate 16 → 21 → 22 /min over 47h; systolic pressure 128 → 114 → 114 mmHg over 43h; heart rate 85 → 106 → 110 /min over 44h; lactate 1.2 → 1.9 mmol/L over 45h; temperature 37.3 → 38.6 → 38.7 °C over 44h. 5 signals across 3 systems (respiratory, circulatory, inflammatory) are moving in the adverse direction within the same window. Individually each change is modest; together they describe one trajectory.

Urgent · Rapidly worsening
Pattern strength61/100 · moderate evidence

Falling perfusion reserve

Systolic pressure 128 → 121 → 114 → 114 mmHg over 43h; heart rate 85 → 101 → 106 → 110 /min over 44h; lactate 1.2 → 1.9 mmol/L over 45h. Falling pressure with rising rate is a compensation pattern — reserve is being consumed before the numbers look critical.

Watch · Worsening
Pattern strength54/100 · higher evidence

Changed since last review · 8 meaningful

Respiratory rate · 19 /min → 22 /min (+3 /min, 26 min ago)rising
Systolic blood pressure · 122 mmHg → 114 mmHg (−8 mmHg, 17 min ago)falling
Heart rate · 95 /min → 110 /min (+15 /min, 1 min ago)rising
Temperature · 38.2 °C → 38.7 °C (+0.5 °C, 4h ago)rising
Creatinine · 1.70 mg/dL → 1.30 mg/dL (−0.40 mg/dL, 1h ago)falling
White cell count · 14.8 ×10⁹/L → 18.1 ×10⁹/L (+3.3 ×10⁹/L, 1h ago)rising
C-reactive protein · 120 mg/L → 190 mg/L (+70 mg/L, 1h ago)rising
Lactate · 1.2 mmol/L → 1.9 mmol/L (+0.7 mmol/L, 1h ago)rising

Reassuring signals · 2

Oxygen saturation · 98 % — in range and steady.
Creatinine · 1.30 mg/dL — recovering toward range.

Synthetic demonstration · engine output requires clinical correlation and is not a diagnosis