Development of a vasopressor control module for testing hemorrhagic shock resuscitation controllers

Area of Science:

• Biomedical Engineering
• Critical Care Medicine
• Physiological Modeling

Background:

• Hemorrhagic shock patients may require vasopressors when fluid resuscitation fails.
• Manual vasopressor titration is challenging in mass casualty or resource-limited settings.
• Developing closed-loop vasopressor adaptive resuscitation controllers (V-ARCs) is hindered by reliance on animal studies.

Purpose of the Study:

• To develop a Vasopressor Control Module (VCM) for a hardware-in-loop automated testbed for resuscitation controllers (HATRC).
• To enable systematic evaluation and development of V-ARCs, reducing dependence on animal testing.

Main Methods:

• Designed a VCM informed by vasopressor administration data from a hemorrhagic shock swine model.
• Incorporated key physiological variables: lag time, real response, overshoot, and pressure-time responsiveness.
• Utilized the VCM within a hardware-in-loop automated testbed for controller evaluation.

Main Results:

• The VCM successfully replicated physiological variability, dose-dependent responsiveness, and disturbance conditions.
• Proof-of-concept testing differentiated the performance of multiple V-ARC designs.
• Demonstrated the VCM's capability to evaluate V-ARC designs under various conditions.

Conclusions:

• Established a flexible, physiologically grounded platform for V-ARC development.
• Reduced the need for extensive animal testing in V-ARC research.
• Future work will enhance physiological modeling and incorporate additional hemodynamic variables.