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.
Abstract:
Patients receiving labor epidurals commonly experience arterial hypotension as a complication of neuraxial block. The purpose of this study was to design an adaptive optimal controller for an infusion system to regulate mean arterial pressure. A state-space model relating mean arterial pressure to Norepinephrine (NE) infusion rate was derived for controller design. A data-driven adaptive optimal control algorithm was developed based on adaptive dynamic programming (ADP). The stability and disturbance rejection ability of the closed-loop system were tested via a simulation model calibrated using available clinical data. Simulation results indicated that the settling time was six minutes and the system showed effective disturbance rejection. The results also demonstrate that the adaptive optimal control algorithm would achieve individualized control of mean arterial pressure in pregnant patients with no prior knowledge of patient parameters.
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