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A microprocessor based feedback controller for mechanical ventilation.

K B Ohlson, D R Westenskow, W S Jordan

    Annals of Biomedical Engineering
    |January 1, 1982
    PubMed
    Summary
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    A novel microcomputer system effectively controlled ventilation by adjusting inspired minute volume based on end-tidal CO2. This system maintained stable arterial PCO2 during increased CO2 production but struggled with ventilation/perfusion changes.

    Area of Science:

    • Biomedical Engineering
    • Respiratory Physiology
    • Critical Care Medicine

    Background:

    • Mechanical ventilation requires precise control of gas exchange.
    • End-tidal CO2 (ETCO2) is a non-invasive indicator of arterial CO2 (PaCO2).
    • Automated feedback systems can optimize ventilator management.

    Purpose of the Study:

    • To develop and evaluate a microcomputer feedback system for mechanical ventilation.
    • To assess the system's ability to maintain target PaCO2 using ETCO2 feedback.
    • To test the system's performance under various physiological challenges.

    Main Methods:

    • A closed-loop microcomputer system controlled ventilator inspired minute volume based on ETCO2.
    • The system was tested in 6 dogs under conditions including NaHCO3 infusion, pulmonary artery occlusion, endobronchial tube occlusion, and air embolism.

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  • Arterial PCO2 (PaCO2) and ETCO2 were continuously monitored.

    • Main Results:

    • The system maintained PaCO2 within 1.2 mm Hg of the target value during a 44% increase in CO2 production.
    • Significant discrepancies (up to 22 mm Hg) between PaCO2 and ETCO2 occurred with altered ventilation/perfusion ratios.
    • The controller effectively compensated for increased CO2 production but was less effective with significant V/Q mismatches.

    Conclusions:

    • Closed-loop ventilation control using ETCO2 is effective for managing CO2 production changes.
    • Ventilation/perfusion mismatches pose a challenge for ETCO2-based feedback control systems.
    • Further refinement is needed for robust performance in complex respiratory conditions.