Model-based management of cardiovascular failure: Where medicine and control systems converge

Abstract

Cardiovascular disease is growing epidemically worldwide, multiplying the impact of increasingly aging populations on intensive care unit (ICU) demand. It is the leading cause of ICU admission, length of stay, mortality and, as a result, cost. Hence, there is a significant need to bring the gains in productivity enabled by automation and control systems technologies, which have arisen in so many sectors, to medicine and this field in particular. This review presents the background to the problem and the main issues arising in care from a control systems technology perspective. It then presents a vision of a more automated future with specific goals in the areas of dynamic systems modeling, system identification and control. These areas are reviewed, followed by specific recommendations for the field, where control systems expertise can be leveraged to best advantage.

A strategy for designing of customized electromechanical actuators of blood pumps

“…The assembled dynamometer measured torque and mechanical power to validate numerical simulations and analytical calculation. [25][26][27][28][29] Figure 7 shows the experimental setup.…”

Low cost circulatory pressure acquisition and fluid infusion rate measurement system for clinical research

“…However, these variables can be insufficient for diagnosing and managing circulatory shock [2] . Increasingly, computational models/ algorithms are being developed, which aim to optimally use ICU monitoring systems and their wealth of clinical data for improving patient outcomes [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . These physiological models have the capacity to provide more effective measurements and protocols for circulatory management [6] , [7] .…”

Risk-Based Care: Let's Think Outside the Box

“…Thus, quantifying the risk, via new metrics or personalized models, would allow the proper assessment of patient response and thus whether (or not) to provide more aggressive ventilation settings, which if done incorrectly increase the risk of cost, length of stay, and mortality. Fluid resuscitation therapy faces a similar contradiction between providing more input to support circulatory and cardiac function, and the ongoing risk of the therapy itself to patient outcome (34,35). Quantifying responsiveness to fluid resuscitation therapy is a "holy grail" of ICU research, as quantifying the response would reduce the risk and make it manageable.…”