Coordinated semi‐adaptive closed‐loop control for infusion of two interacting medications
Coordinated semi‐adaptive closed‐loop control for infusion of two interacting medications
复制标题
两种相互作用药物输注的协调半自适应闭环控制
DOI：
10.1002/acs.2832
复制
发表时间：
2018
影响因子：
3.1
通讯作者：
J. Hahn
中科院分区：
文献类型：
--
作者：
Xin Jin;Chang;S. Shipley;G. Dumont;J. Hahn
本文提出了一种协调和半自适应闭环控制方法，用于输注2种相互作用的药物。该方法由上层协调控制器和下层半自适应控制器组成。协调控制器基于患者的估计剂量-反应关系递归地调整参考目标，以确保患者可以实现它们。半自适应控制器将患者输出驱动到参考目标，同时在线估计患者的剂量反应关系。通过这种方式，控制器能够适应无法实现的护理人员指定的参考目标，并对个体患者的药物需求做出响应。为了建立所提出的方法，我们开发了以下内容：（1）线性双输入双输出剂量响应模型;（2）双输入双输出半自适应控制器，用于调节患者输出，同时适应患者模型中的高灵敏度参数;以及（3）协调控制器，用于调整协调护理人员输入和药物使用的参考目标。所提出的方法被应用到一个示例场景中，其中心输出量和呼吸率通过在计算机模拟设置中输注丙泊酚和瑞芬太尼来调节。结果表明，协调半自适应控制可以（1）跟踪可实现的参考目标，具有一致的瞬态和稳态性能和（2）弹性调整不可实现的参考目标，可实现的。
This paper presents a coordinated and semi‐adaptive closed‐loop control approach to the infusion of 2 interacting medications. The proposed approach consists of an upper‐level coordination controller and a lower‐level semi‐adaptive controller. The coordination controller recursively adjusts the reference targets based on the estimated dose‐response relationship of a patient to ensure that they can be achieved by the patient. The semi‐adaptive controller drives the patient outputs to the reference targets while estimating the patient's dose‐response relationship online. In this way, the controller is resilient to unachievable caregiver‐specified reference targets and responsive to the medication needs of individual patients. To establish the proposed approach, we developed the following: (1) a linear two‐input–two‐output dose‐response model; (2) a two‐input–two‐output semi‐adaptive controller to regulate the patient outputs while adapting high‐sensitivity parameters in the patient model; and (3) a coordination controller to adjust the reference targets that reconcile caregiver inputs and medication use. The proposed approach was applied to an example scenario in which cardiac output and respiratory rate are regulated via infusion of propofol and remifentanil in an in silico simulation setting. The results show that the coordinated semi‐adaptive control could (1) track achievable reference targets with consistent transient and steady‐state performance and (2) resiliently adjust the unachievable reference targets to achievable ones.