Autoregressive With Exogenous Input (ARX) Decision Support for Blood Pressure Maintenance During Cesarean Delivery Under Spinal Anesthesia: A Prospective Pilot Study With Matched Nonconcurrent Controls
<b>Question:</b> In pregnant patients at term undergoing elective cesarean delivery under spinal anesthesia, can a real-time ARX algorithm accurately forecast MAP and support vasopressor management? <b>Findings:</b> One-minute-ahead forecasts were accurate (RMSE 3.71 mmHg), and ARX-guided care was associated with a shorter duration of hypotension and a higher phenylephrine dose versus matched nonconcurrent controls <b>Meaning:</b> Real-time MAP forecasting is feasible and warrants randomized evaluation to confirm clinical benefit and characterize trade-offs.
Authors
- Sherwin C. Davoud
- Ricardo Kleinlein (ORCID: https://orcid.org/0000-0002-7313-7601)
- Başak Özaslan (ORCID: https://orcid.org/0000-0002-8537-1892)
- N.J. Wheeler (ORCID: https://orcid.org/0000-0002-0310-3668)
- Eleonora M. Aiello (ORCID: https://orcid.org/0000-0001-5129-8829)
- Vesela Kovacheva (ORCID: https://orcid.org/0000-0001-7367-3394)
- Francis J. Doyle (ORCID: https://orcid.org/0000-0002-3293-9114)
- Niharika Mahesh
- Prakhar Kapoor
Institutions
- Brigham and Women's Hospital (US)
- Harvard University (US)
- University of Pavia (IT)
- Brown University (US)
Publication Details
- Journal
- medRxiv
- Published
- 2026-02-05
- DOI
- https://doi.org/10.64898/2026.02.03.26345255
- Primary Topic
- Hemodynamic Monitoring and Therapy
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Alfred P. Sloan Foundation
- Brigham and Women's Hospital
- Massachusetts General Hospital
- Harvard University
- Harvard Catalyst
- Massachusetts Life Sciences Center
- Insulet Corporation
- National Institutes of Health
- National Heart, Lung, and Blood Institute
- Office of Research on Women's Health
- National Center for Advancing Translational Sciences