latest obs 10m ago

Patient intelligence · showcase: respiratory-deterioration

S. Nakamura · 67M

Bed 06 · COPD · hospital day 7 · Infective exacerbation of COPD; target SpO₂ 88–92 % documented.

Context: Prednisolone day 6 · Nebulised bronchodilators

VYZR Care RPP Engineconnecting…

Concerning · Worsening

Oxygen requirement 1.6 → 3.0 → 3.3 → 3.8 L/min over 44h; respiratory rate 19 → 25 → 26 → 27 /min over 44h; SpO₂ 91 → 90 → 90 → 89 % over 44h. Two or more respiratory signals are moving together — a work-of-breathing trajectory, not a single reading. If the current slope continues: O₂ ≈ 6.2 (5.5–7.0 L/min) at 24h, crossing 6 L/min in ~22h; RR ≈ 33 (31–34 /min) at 24h, crossing RR 30/min in ~13h; SpO₂ ≈ 88 (87–90 %) at 24h. 1 related pattern also active (systemic infection trajectory).

Preparing narrative…

01 · Recognized · last 2 d

Concerning · Worsening

Rising respiratory burden

Pattern strength49/100 · higher evidence

Experimental explainable index, not a probability. 3 of 3 expected signals available 109 measurements across supporting signals

Hover, touch, or use arrow keys to inspect

Measured · 36 points · last 4h agoProjected · shaded = uncertainty band

3.8 L/min (+0.5 L/min since previous), above range, stable · 5 consecutive falls.

Supplemental oxygen

3.8 L/min · stable · 5 consecutive falls

Respiratory rate

27 /min · rising · +5 /min/24h · 2 consecutive rises

Oxygen saturation

89 % · stable · chronic, unchanged since baseline

02 · Predicted

24hhigher evidence confidence

If the current slope continues: O₂ ≈ 6.2 (5.5–7.0 L/min) at 24h, crossing 6 L/min in ~22h; RR ≈ 33 (31–34 /min) at 24h, crossing RR 30/min in ~13h; SpO₂ ≈ 88 (87–90 %) at 24h.

Next in line if this continues: Continued rise in oxygen requirement and respiratory rate, with SpO₂ eventually unable to be held.

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

Projections · 3 made · 0 withheld

Supplemental oxygenols-recent · fitted on 6 points · slope +0.09 L/min/h

+6h · Sep 25 21:41

4.6 (4–5.2)

+12h · Sep 26 03:41

5.2 (4.5–5.8)

+24h · Sep 26 15:41

6.2 (5.5–7)

6 L/min in ~22h if the current slope continues (at Sep 26 13:41).

Respiratory rateols-recent · fitted on 7 points · slope +0.23 /min/h

+6h · Sep 25 21:41

28 (27–30)

+12h · Sep 26 03:41

30 (29–31)

+24h · Sep 26 15:41

33 (31–34)

RR 30/min in ~13h if the current slope continues (at Sep 26 04:41).

Oxygen saturationols-recent · fitted on 7 points · slope -0.03 %/h

+6h · Sep 25 21:41

89 (88–90)

+12h · Sep 26 03:41

89 (87–90)

+24h · Sep 26 15:41

88 (87–90)

Alternative explanations

· Transient desaturation with mobilisation, sleep or sputum plugging rather than sustained deterioration.
· Oxygen titrated up empirically without a new physiological need — check whether the target range was documented.
· Chronic hypercapnic physiology — the SpO₂ target may legitimately be lower (scale 2).
· Anxiety or pain driving respiratory rate without gas-exchange failure.

04 · Consider now

Consider progressive pneumonia, aspiration, pulmonary embolism, bronchospasm and atelectasis.

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 10 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 O₂ requirementworsening V/Q mismatch or shuntHypoxaemia despite supplementation

Rising respiratory rateincreased work of breathingRespiratory muscle fatigue → hypercapnia

Evidence · 9 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 progressive pneumonia, aspiration, pulmonary embolism, bronchospasm and atelectasis.

Missing information

Work of breathing, auscultation findings and fluid balance are not in the structured record.

Investigate

Consider arterial or venous blood gas and chest imaging; review recent cultures.

Monitor

Consider increasing observation frequency and continuous SpO₂ monitoring while the requirement is rising.

Medication review

Review sedatives/opioids, fluid prescriptions, and whether nebulised/inhaled therapy is current.

Level of care

Consider early critical-care awareness if oxygen exceeds 6 L/min, RR ≥ 30/min, or SpO₂ cannot be maintained.

Other active patterns · 1

Systemic infection trajectory

Heart rate 88 → 99 → 102 /min over 48h; respiratory rate 19 → 26 → 27 /min over 44h; white cells 10.2 → 11.8 ×10⁹/L over 47h; CRP 45 → 58 mg/L over 47h. Inflammatory markers are moving with a physiological response — the pattern is systemic, not just a lab value. Occurring despite current antibiotic therapy (recorded context).

Concerning · Worsening

Pattern strength40/100 · moderate evidence

Changed since last review · 5 meaningful

Respiratory rate · 23 /min → 27 /min (+4 /min, 25 min ago)rising

Supplemental oxygen · 3.0 L/min → 3.8 L/min (+0.8 L/min, 4h ago)rising

Heart rate · 96 /min → 102 /min (+6 /min, 26 min ago)rising

White cell count · 10.2 ×10⁹/L → 11.8 ×10⁹/L (+1.6 ×10⁹/L, 1h ago)rising

C-reactive protein · 45 mg/L → 58 mg/L (+13 mg/L, 1h ago)rising

Oxygen saturation · 90 % → 89 % (−1 %, 10 min ago)flat

Systolic blood pressure · 128 mmHg → 125 mmHg (−3 mmHg, 16 min ago)flat

Temperature · 36.9 °C → 36.9 °C (±0.0 °C, 11 min ago)flat

Reassuring signals · 3

Oxygen saturation · 89 % — out of range but unchanged across 37 samples; chronic, not escalated.

Systolic blood pressure · 125 mmHg — in range and steady.

Temperature · 36.9 °C — in range and steady.

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