A Dual Closed-Loop Control System for Mechanical Ventilation

Tehrani, Fleur T.; Rogers, Mark W.; Lo, Takkin; Malinowski, Thomas P; Afuwape, Samuel; Lum, Michael; Grundl, Brett; Terry, Michael H.

doi:10.1023/b:jocm.0000032744.99885.38

Cited by 57 publications

(23 citation statements)

References 25 publications

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“…The recent developments of ventilators technology have provided electro-mechanical devices able to perform the automatic control of artificial ventilation through a microprocessor feedback acting between preset and actual measured values of basic physical parameters [4][5][6]. Nevertheless, the crucial still unsolved question is the optimal choice of ventilation modality and parameter setting to be applied to the specific patient and pathology [7,8].…”

Section: Introductionmentioning

confidence: 99%

Advanced lung ventilation system (ALVS) with linear respiratory mechanics assumption for waveform optimization of dual-controlled ventilation

Montecchia

Guerrisi

Canichella

2007

Medical Engineering & Physics

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Section: Introductionmentioning

confidence: 99%

Advanced lung ventilation system (ALVS) with linear respiratory mechanics assumption for waveform optimization of dual-controlled ventilation

Montecchia

Guerrisi

Canichella

2007

Medical Engineering & Physics

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“…It uses the patient's physiological and ventilatory data to determine the optimal levels of ventilatory J Clin Monit Comput (2012) 26:207-215 209 parameters. It is designed to minimize the work rate of breathing and includes the features of a ventilatory technique known as Adaptive Support Ventilation (ASV), [1,24] plus additional features for oxygenation and weaning. However, FLEX is not designed to predict the effects of different ventilatory parameters on patient's blood gases.…”

Section: Methods Of Testing the Systemmentioning

confidence: 99%

“…Since their development, these models have been used by many researchers for teaching and research purposes. Examples of the extensive use of the models can be found in References [21][22][23][24][25]. Figure 1 shows a schematic block diagram of the modified model.…”

Section: Description Of the Systemmentioning

confidence: 99%

A model-based decision support system for critiquing mechanical ventilation treatments

Tehrani

Abbasi

2012

J Clin Monit Comput

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A computerized system for critiquing mechanical ventilation treatments is presented that can be used as an aide to the intensivist. The presented system is based on the physiological model of the subject's respiratory system. It uses modified versions of previously developed models of adult and neonatal respiratory systems to simulate the effects of different ventilator treatments on the patient's blood gases. The physiological models that have been used for research and teaching purposes by many researchers in the field include lungs, body tissue, and the brain tissue. The lung volume is continuously time-varying and the effects of shunt in the lung, changes in cardiac output and cerebral blood flow, and the arterial transport delays are included in the system. Evaluation tests were done on adult and neonate patients with different diagnoses. In both groups combined, the differences between the arterial partial pressures of CO(2) predicted by the system and the experimental values were 1.86 ± 1.6 mmHg (mean ± SD), and the differences between the predicted arterial hemoglobin oxygen saturation values, S(aO2), and the experimental values measured by using pulse oximetry, S(pO2), were 0.032 ± 0.02 (mean ± SD). The proposed system has the potential to be used alone or in combination with other decision support systems to set ventilation parameters and optimize treatment for patients on mechanical ventilation.

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“…Among the different systems proposed for implementing DCV [5,[15][16][17][18][19][20], ALVS exhibits the following suitable functional features [6,7]: 1) opportunity of applying any airways pressure waveform of clinical interest during the time of controlled breathing without distortions, i.e. identical to that selected;…”

Section: Methodsmentioning

confidence: 99%

Harmonic excitation of linear respiratory mechanics for physiological dual controlled ventilation

Montecchia¹

2012

JBiSE

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The theoretical approach along with the rationale of harmonic excitation modality (HEM) applied as optimal dual controlled ventilation (DCV) to anaesthetized or severe brain injured patients, whose respiretory mechanics can be properly assumed steady and linear, are presented and discussed. The design criteria of an improved version of the Advanced Lung Ventilation System (ALVS), including HEM in its functional features, are described in details. In particular, the elimination of any undesiderable artificial distortion affecting the respiratory and ventilation pattern waveforms is achieved by maintaining continuous forever the airflow inside the ventilation circuit, ensuring also the highest level of safety for patient in any condition. In such a way, the full-time compatibility of controlled breathings with spontaneous breathing activity of patient during continuous positive airways pressure (CPAP) or bilevel positive airways pressure (BiPAP) ventilation modalities and during assisted/controlled ventilation(A/CV), includeing also synchronized or triggered ventilation modalities, is an intrinsic innovative feature of the system available for clinical application. As expected and according to the clinical requirements, HEM provides for physiological respiratory and ventilation pattern waveforms together with optimal "breath to breath" feedback control of lung volume driven by an improved diagnostic measurement procedure, whose outputs are also vital for adapting all the pre-set ventilation parameters to the current value of the respiratory parameters of patient. The results produced by software simulations concerning both adult and neonatal patients in different clinical conditions are completely consistent with those obtained by the theoretical treatment, showing that HEM reaches the best performances from both clinical and engineering points of view.

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A Dual Closed-Loop Control System for Mechanical Ventilation

Cited by 57 publications

References 25 publications

Advanced lung ventilation system (ALVS) with linear respiratory mechanics assumption for waveform optimization of dual-controlled ventilation

Advanced lung ventilation system (ALVS) with linear respiratory mechanics assumption for waveform optimization of dual-controlled ventilation

A model-based decision support system for critiquing mechanical ventilation treatments

Harmonic excitation of linear respiratory mechanics for physiological dual controlled ventilation

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