AI-Driven Early Warning System for Sepsis Deterioration in Post-Operative Cardiac Surgery Patients
DOI:
https://doi.org/10.15662/IJEETR.2026.0802204Keywords:
Sepsis, Artificial Intelligence, Internet of Things (IoT), Early Warning System, ICU Monitoring, Machine Learning.Abstract
Background: Sepsis represents a critical life-threatening condition characterized by dysregulated host response to infection, contributing significantly to intensive care unit mortality worldwide. Post-operative cardiac surgery patients face elevated sepsis risk due to invasive procedures, prolonged mechanical ventilation, and immunosuppression. Early physiological indicators often remain subtle and non-specific, challenging timely diagnosis through conventional monitoring approaches.
Objective: This study develops and evaluates an artificial intelligence-driven early warning system combining Internet of Things technology with machine learning algorithms for real-time sepsis detection in post-cardiac surgery patients.
Methods: The system integrates non-invasive wearable sensors measuring heart rate, heart rate variability, oxygen saturation, and body temperature. An ESP8266 microcontroller processes physiological signals and transmits data through WiFi connectivity. Machine learning algorithms establish patient-specific baseline profiles during post-operative stabilization, employing statistical modeling and anomaly detection to identify deviations indicating sepsis onset.
Results: Experimental prototype testing demonstrated detection accuracy of 94-96% with improved sensitivity and specificity compared to threshold-based monitoring systems. The adaptive baseline approach reduced false alarm rates while maintaining early detection capability. Real-time edge processing enabled response times under 2 seconds.
Conclusion: The proposed AI-driven monitoring system provides personalized, proactive sepsis detection with significant improvements in accuracy and responsiveness. Integration of IoT-based continuous monitoring with adaptive machine learning offers promising advancement toward reducing ICU mortality through earlier clinical intervention.
References
1. Rudd, K. E., Johnson, S. C., Agesa, K. M., et al. (2020). Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet, 395(10219), 200-211.
2. Lomivorotov, V. V., Efremov, S. M., Kirov, M. Y., et al. (2017). Low-cardiac-output syndrome after cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 31(1), 291-308.
3. Boyle, E. M., Pohlman, T. H., Johnson, M. C., & Verrier, E. D. (1997). Endothelial cell injury in cardiovascular surgery: the systemic inflammatory response. The Annals of Thoracic Surgery, 63(1), 277-284.
4. Singer, M., Deutschman, C. S., Seymour, C. W., et al. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315(8), 801-810.
5. Sendelbach, S., & Funk, M. (2013). Alarm fatigue: a patient safety concern. AACN Advanced Critical Care, 24(4), 378-386.
6. Islam, S. M. R., Kwak, D., Kabir, M. H., Hossain, M., & Kwak, K. S. (2015). The internet of things for health care: a comprehensive survey. IEEE Access, 3, 678-708.
7. Nemati, S., Holder, A., Razmi, F., et al. (2018). An interpretable machine learning model for accurate prediction of sepsis in the ICU. Critical Care Medicine, 46(4), 547-553.
8. Zhang, P., Wang, Y., Li, X., et al. (2023). The application of artificial intelligence in the management of sepsis. Frontiers in Medicine, 10, 1174408.
9. Wynne-Jones, G., & Karanicolas, P. J. (2024). Postoperative infection following cardiac surgery: epidemiology and risk factors. Journal of Thoracic Disease, 16(2), 1245-1258.
10. Kumar, A., Roberts, D., Wood, K. E., et al. (2006). Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical Care Medicine, 34(6), 1589-1596.
11. Seymour, C. W., Gesten, F., Prescott, H. C., et al. (2017). Time to treatment and mortality during mandated emergency care for sepsis. New England Journal of Medicine, 376(23), 2235-2244.
12. Likosky, D. S., Wallace, A. S., Prager, R. L., et al. (2018). Sources of variation in hospital-level infection rates after coronary artery bypass grafting. JAMA Surgery, 153(11), 1014-1020.
13. C.Nagarajan and M.Madheswaran - ‘Stability Analysis of Series Parallel Resonant Converter with Fuzzy Logic Controller Using State Space Techniques’- Taylor &Francis, Electric Power Components and Systems, Vol.39 (8), pp.780-793, May 2011. DOI: 10.1080/15325008.2010.541746
14. C.Nagarajan and M.Madheswaran - ‘Experimental verification and stability state space analysis of CLL-T Series Parallel Resonant Converter’ - Journal of Electrical Engineering, Vol.63 (6), pp.365-372, Dec.2012. DOI: 10.2478/v10187-012-0054-2
15. C.Nagarajan and M.Madheswaran - ‘Performance Analysis of LCL-T Resonant Converter with Fuzzy/PID Using State Space Analysis’- Springer, Electrical Engineering, Vol.93 (3), pp.167-178, September 2011. DOI 10.1007/s00202-011-0203-9
16. S.Tamilselvi, R.Prakash, C.Nagarajan,“Solar System Integrated Smart Grid Utilizing Hybrid Coot-Genetic Algorithm Optimized ANN Controller” Iranian Journal Of Science And Technology-Transactions Of Electrical Engineering, DOI10.1007/s40998-025-00917-z,2025
17. S.Tamilselvi, R.Prakash, C.Nagarajan,“ Adaptive sliding mode control of multilevel grid-connected inverters using reinforcement learning for enhanced LVRT performance” Electric Power Systems Research 253 (2026) 112428, doi.org/10.1016/j.epsr.2025.112428
18. S.Thirunavukkarasu, C. Nagarajan, 2024, “Performance Investigation on OCF and SCF study in BLDC machine using FTANN Controller," Journal of Electrical Engineering And Technology, Volume 20, pages 2675–2688, (2025), doi.org/10.1007/s42835-024-02126-w
19. C. Nagarajan, M.Madheswaran and D.Ramasubramanian- ‘Development of DSP based Robust Control Method for General Resonant Converter Topologies using Transfer Function Model’- Acta Electrotechnica et Informatica Journal , Vol.13 (2), pp.18-31,April-June.2013, DOI: 10.2478/aeei-2013-0025.
20. C.Nagarajan and M.Madheswaran - ‘DSP Based Fuzzy Controller for Series Parallel Resonant converter’- Springer, Frontiers of Electrical and Electronic Engineering, Vol. 7(4), pp. 438-446, Dec.12. DOI 10.1007/s11460-012-0212-0.
21. C.Nagarajan and M.Madheswaran - ‘Experimental Study and steady state stability analysis of CLL-T Series Parallel Resonant Converter with Fuzzy controller using State Space Analysis’- Iranian Journal of Electrical & Electronic Engineering, Vol.8 (3), pp.259-267, September 2012.
22. C.Nagarajan and M.Madheswaran, “Analysis and Simulation of LCL Series Resonant Full Bridge Converter Using PWM Technique with Load Independent Operation” has been presented in ICTES’08, a IEEE / IET International Conference organized by M.G.R.University, Chennai.Vol.no.1, pp.190-195, Dec.2007
23. Suganthi Mullainathan, Ramesh Natarajan, “An SPSS and CNN modelling based quality assessment using ceramic materials and membrane filtration techniques”, Revista Materia (Rio J.) Vol. 30, 2025, DOI: https://doi.org/10.1590/1517-7076-RMAT-2024-0721
24. M Suganthi, N Ramesh, “Treatment of water using natural zeolite as membrane filter”, Journal of Environmental Protection and Ecology, Volume 23, Issue 2, pp: 520-530,2022
25. Pierrakos, C., & Vincent, J. L. (2010). Sepsis biomarkers: a review. Critical Care, 14(1), R15.
26. Sendak, M. P., Ratliff, W., Sarro, D., et al. (2020). Real-world integration of a sepsis deep learning technology into routine clinical care: implementation study. JMIR Medical Informatics, 8(7), e15182.
27. Giannini, H. M., Ginestra, J. C., Chivers, C., et al. (2019). A machine learning algorithm to predict severe sepsis and septic shock: development, implementation, and impact on clinical practice. Critical Care Medicine, 47(11), 1485-1492.
28. Kiran, A., Rubini, P., & Kumar, S. S. (2025). Comprehensive review of privacy, utility and fairness offered by synthetic data. IEEE Access.
29. Padmapriya, V. M., Thenmozhi, K., Hemalatha, M., Thanikaiselvan, V., Lakshmi, C., Chidambaram, N., & Rengarajan, A. (2025). Secured IIoT against trust deficit-A flexi cryptic approach. Multimedia Tools and Applications, 84(9), 5625-5652.
30. Pandi Prabha, S., & Rengarajan, A. (2025, February). Decentralized Resource Allocation Model Using Multi-agent Reinforcement Learning for Cloud Environment. In International Conference on Universal Threats in Expert Applications and Solutions (pp. 71-82). Singapore: Springer Nature Singapore.
31. Anbazhagan, K. (2024). Trustworthy and Adaptive AI Systems for Enterprise Analytics Cybersecurity and Decision Optimization Using API-First and Cloud-Native Architectures. International Journal of Technology, Management and Humanities, 10(03), 65-74.
32. Gopinathan, V. R. (2025). AI-Powered Kubernetes Orchestration for Complex Cloud-Native Workloads. International Journal of Research Publications in Engineering, Technology and Management (IJRPETM), 8(6), 13215-13225.
33. Jagadeesh, S., & Sugumar, R. (2017). A Comparative study on Artificial Bee Colony with modified ABC algorithm. European Journal of Applied Sciences, 9(5), 243-248.
34. Sruthi, R. S., Ananya, S., & Murugeshwari, B. (2010). Web Based Virtual Control System Laboratory and On-Line Temperature Control of Electrophoresis Equipment using LabVIEW. International Journal of Computer Applications, 975, 8887.
35. Gopinathan, V. R. (2025). Intelligent Workload Scheduling for Telecom Cloud Architecture Using Reinforcement Learning. International Journal of Research Publications in Engineering, Technology and Management (IJRPETM), 8(6), 13244-13255.
36. Rajasekar, M., (2024). Secure Digital Banking with Federated AI: An AWS Cloud-Based Predictive Analytics Architecture for Financial Risk Intelligence. International Journal of Research and Applied Innovations, 7(3), 10735-10740.
37. Anand, L., Tyagi, R., & Mehta, V. (2024, January). Food recognition using deep learning for recipe and restaurant recommendation. In Proceedings of Eighth International Conference on Information System Design and Intelligent Applications (pp. 269-279). Singapore: Springer Nature Singapore.





