Development and In Silico Evaluation of a Model-Based Closed-Loop Fluid Resuscitation Control Algorithm
Development and In Silico Evaluation of a Model-Based Closed-Loop Fluid Resuscitation Control Algorithm
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DOI：
10.1109/tbme.2018.2880927
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发表时间：
2019-07-01
影响因子：
4.6
通讯作者：
Hahn, Jin-Oh
中科院分区：
文献类型：
--
作者：
Jin, Xin;Bighamian, Ramin;Hahn, Jin-Oh
目的：开发和评估基于模型的基于血容量反馈的闭环液体复苏控制算法。方法：利用低阶集总参数血容量动力学模型，开发了一种基于模型的液体复苏自适应控制算法，然后根据详细的循环生理学机制模型进行计算机评估。该算法分两步运行：1）通过系统识别，根据患者对初始液体推注的血容量分数反应，对血容量动态模型进行个性化； 2)基于个体化血容量动力学模型的自适应控制律调节患者的血容量。结果：该算法能够跟踪血容量设定点，并准确估计和监测患者的绝对血容量水平。该算法显着优于基于群体的比例积分微分控制。结论：基于模型的闭环液体复苏控制算法的开发可以实现血容量的调节和绝对血容量水平的监测。意义：基于模型的闭环液体复苏算法可能为标准化和针对患者的治疗提供机会，并减少临床医生的工作量。
Objective: To develop and evaluate in silico, a model-based closed-loop fluid resuscitation control algorithm via blood volume feedback. Methods: A model-based adaptive control algorithm for fluid resuscitation was developed by leveraging a low-order lumped-parameter blood volume dynamics model, and then, in silico evaluated based on a detailed mechanistic model of circulatory physiology. The algorithm operates in two steps: 1) the blood volume dynamics model is individualized based on the patient's fractional blood volume response to an initial fluid bolus via system identification; and 2) an adaptive control law built on the individualized blood volume dynamics model regulates the blood volume of the patient. Results: The algorithm was able to track the blood volume set point as well as accurately estimate and monitor the patient's absolute blood volume level. The algorithm significantly outperformed a population-based proportional-integral-derivative control. Conclusion: Model-based development of closed-loop fluid resuscitation control algorithms may enable the regulation of blood volume and monitoring of absolute blood volume level. Significance: Model-based closed-loop fluid resuscitation algorithm may offer opportunities for standardized and patient-tailored therapy and reduction of clinician workload.