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A closed-loop mechanical ventilation controller with explicit objective functions.

Frederico C Jandre1, Alexandre V Pino, Ivanir Lacorte

  • 1Biomedical Engineering Program/COPPE, Federal University of Rio de Janeiro, RJ 21945-970, Brazil. jandre@peb.ufrj.br

IEEE Transactions on Bio-Medical Engineering
|May 11, 2004
PubMed
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A novel closed-loop lung ventilation controller effectively tracks end-tidal CO2 and optimizes positive end-expiratory pressure (PEEP) to minimize respiratory system elastance, aiding in lung injury reduction.

Area of Science:

  • Biomedical Engineering
  • Respiratory Physiology
  • Control Systems

Background:

  • Mechanical ventilation is crucial for respiratory support.
  • Optimizing ventilation parameters like PEEP and CO2 levels is vital to prevent ventilator-induced lung injury (VILI).
  • Current methods for PEEP titration and CO2 control can be time-consuming and may not be consistently optimal.

Purpose of the Study:

  • To design and evaluate a closed-loop lung ventilation controller.
  • To achieve precise tracking of end-tidal CO2 pressure (PetCO2).
  • To automatically determine the positive end-expiratory pressure (PEEP) that minimizes estimated respiratory system elastance (Ers,e) and potentially reduces lung injury.

Main Methods:

  • A closed-loop controller integrating a modified PI controller for PetCO2 and a gradient descent method for PEEP was developed.

Related Experiment Videos

  • Respiratory mechanics parameters were estimated using the recursive least squares (RLS) method.
  • The controller was tested in six paralyzed piglets, with automated PEEP control runs and manual PEEP titration.

    • Main Results:

    • Automated PEEP control achieved a minimum Ers,e of 37.0 ± 4.5 cmH2O·L⁻¹, with an associated PEEP of 6.5 ± 1.0 cmH2O, in 235 ± 182 seconds.
    • PetCO2 control demonstrated a rise time of 53 ± 22 s and an absolute overshoot/undershoot of 3 ± 1 mmHg, with a settling time of 145 ± 72 s.
    • Controller performance in PEEP control was comparable to manual titration, and CO2 dynamics approximated physiological responses.

    Conclusions:

    • The developed closed-loop controller can effectively manage PetCO2 and optimize PEEP for reduced lung elastance.
    • This controller facilitates the implementation and evaluation of objective functions aimed at clinical goals and lung injury reduction.
    • The system shows promise for improving mechanical ventilation strategies and patient outcomes.