Before revision: Sepsis is the leading cause of mortality in the ICU, responsible for 6\% of all hospitalizations and 35\% of all in-hospital deaths in USA. However, there is no universally agreed upon strategy for vasopressor and fluid administration. It has also been observed that different patients respond differently to treatment, highlighting the need for individualized treatment. Vasopressors and fluids are administrated with specific effects to cardiovascular physiology in mind and medical researchhas suggested that physiologic, hemodynamically guided, approaches to treatment. Thus we propose a novel approach, exploiting and unifying complementary strengths of Mathematical Modelling, Deep Learning, Reinforcement Learning and Uncertainty Quantification, to learn individualized, safe, and uncertainty aware treatment strategies.
After revision: Sepsis is a potentially life threatening inflammatory response to infection or severe tissue damage. It has a highly variable clinical course, requiring constant monitoring of the patient's state to guide the management of intravenous fluids and vasopressors, among other interventions. Despite decades of research, there's still debate among experts on optimal treatment. Here, we combine for the first time, distributional deep reinforcement learning with mechanistic physiological models to find personalized sepsis treatment strategies.