During mechanical ventilation, patient-ventilator disharmony is frequently observed and may result in increased breathing effort, compromising the patients comfort and recovery. This circumstance requires clinical intervention and becomes challenging when verbal communication is difficult. In this work, we propose a brain computer interface (BCI) to automatically and non-invasively detect patient-ventilator disharmony from electroencephalographic (EEG) signals: a brain-ventilator interface (BVI). Our framework exploits the cortical activation provoked by the inspiratory compensation when the subject and the ventilator are desynchronized. Use of a one-class approach and Riemannian geometry of EEG covariance matrices allows effective classification of respiratory states. The BVI is validated on nine healthy subjects that performed different respiratory tasks that mimic a patient-ventilator disharmony. Classification performances, in terms of areas under ROC curves, are significantly improved using EEG signals compared to detection based on air flow. Reduction in the number of electrodes that can achieve discrimination can often be desirable (e.g. for portable BCI systems). By using an iterative channel selection technique, the Common Highest Order Ranking (CHOrRa), we find that a reduced set of electrodes (n=6) can slightly improve for an intra-subject configuration, and it still provides fairly good performances for a general inter-subject setting. Results support the discriminant capacity of our approach to identify anomalous respiratory states, by learning from a training set containing only normal respiratory epochs. The proposed framework opens the door to brain-ventilator interfaces for monitoring patients breathing comfort and adapting ventilator parameters to patient respiratory needs.
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