Mathematical model and minimal measurement system for optimal control of heated humidifiers in neonatal ventilation

The control of thermo-hygrometric conditions of gas delivered in neonatal mechanical ventilation appears to be a particularly difficult task, mainly due to the vast number of parameters to be monitored and the control strategies of heated humidifiers to be adopted. In the present paper, we describe the heat and fluid exchange occurring in a heated humidifier in mathematical terms; we analyze the sensitivity of the relative humidity of outlet gas as a function of thermo-hygrometric and fluid-dynamic parameters of delivered gas; we propose a control strategy that will enable the stability of outlet gas thermo-hygrometric conditions. The mathematical model is represented by a hyper-surface containing the functional relations between the input variables, which must be measured, and the output variables, which have to remain constant. Model sensitivity analysis shows that heated humidifier efficacy and stability of outlet gas thermo-hygrometric conditions are principally influenced by four parameters: liquid surface temperature, gas flow rate, inlet gas temperature and inlet gas relative humidity. The theoretical model has been experimentally validated in typical working conditions of neonatal applications. The control strategy has been implemented by a minimal measurement system composed of three thermometers, a humidity sensor, and a flow rate sensor, and based on the theoretical model. Outlet relative humidity, contained in the range 90+/-4% and 94+/-4%, corresponding with temperature variations in the range 28+/-2 degrees C and 38+/-2 degrees C respectively, has been obtained in the whole flow rate range typical of neonatal ventilation from 1 to 10 L/min. We conclude that in order to obtain the stability of the thermo-hygrometric conditions of the delivered gas mixture: (a) a control strategy with a more complex measurement system must be implemented (i.e. providing more input variables); (b) and the gas may also need to be pre-warmed before entering the humidifying chamber.