Adaptive optimal target controlled infusion algorithm to prevent hypotension associated with labor epidural: An
Sherwin Davoud1, Weinan Gao2, Efrain Riveros-Perez1
1Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, 1120 15th st, Augusta, GA 30912, United States of America.
ISA Transactions
|December 10, 2019
Summary
This study developed an adaptive optimal controller to manage arterial hypotension during labor epidurals. The system uses adaptive dynamic programming for individualized mean arterial pressure regulation in pregnant patients.
Area of Science:
- Anesthesiology and Critical Care
- Biomedical Engineering
- Control Systems
Background:
- Labor epidurals can cause arterial hypotension, a common complication.
- Effective management of mean arterial pressure (MAP) is crucial during labor.
- Neuraxial blocks can lead to significant hemodynamic changes.
Purpose of the Study:
- To design an adaptive optimal controller for an infusion system.
- To regulate mean arterial pressure (MAP) in patients receiving labor epidurals.
- To address the complication of arterial hypotension post-neuraxial block.
Main Methods:
- Developed a state-space model linking MAP to Norepinephrine (NE) infusion rate.
- Implemented a data-driven adaptive optimal control algorithm using adaptive dynamic programming (ADP).
- Validated system stability and disturbance rejection using a clinical data-calibrated simulation model.
Main Results:
- The closed-loop system demonstrated effective disturbance rejection capabilities.
- Achieved a settling time of six minutes for MAP regulation.
- The adaptive optimal control algorithm showed potential for individualized MAP control without prior patient parameter knowledge.
Conclusions:
- Adaptive dynamic programming offers a viable approach for MAP regulation during labor epidurals.
- The developed controller can provide individualized hemodynamic management.
- This technology may improve patient safety by mitigating hypotension complications.
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