On the Feasibility of Automated Mechanical Ventilation Control Through EIT.
On the Feasibility of Automated Mechanical Ventilation Control Through EIT.
复制标题
通过 EIT 进行自动机械通气控制的可行性。
DOI：
10.1109/tbme.2018.2798812
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Tregidgo HFJ
中科院分区：
文献类型：
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作者：
Tregidgo HFJ
目的论证电阻抗断层成像(EIT)与肺功能模型相结合的可行性，以恢复参数并为机械通气控制提供信息。方法将肺功能的分室常微分方程组模型耦合到EIT的仿真中，假设建模和运动跟踪准确，生成体积电导率的时间序列值。根据总风量流量对这些值进行区分和归一化，以恢复区域风量和流量。这些通风分布被用来恢复肺的局部阻力和弹性特性。结果通气量分布是可恢复的，气流欧氏范数误差小于9%，流量欧氏范数误差小于3%。这些参数也是可恢复的，尽管阻力值的误差比弹性值高。所构建的对照具有最小半正则，从而得到有界的幅度和最小的梯度。结论利用EIT恢复局部通风分布和肺参数是可行的。这些参数然后可以用于基于模型的控制方案，以提供患者特定的护理。意义对于肺重症监护患者来说，机械通气是一种挽救生命的干预措施，需要仔细校准压力设置。压力的大小和梯度都可能导致呼吸机所致的肺损伤。通过检索局部肺参数，可以设计针对患者的呼吸机控制，以减少损伤。
ObjectiveThis paper aims to demonstrate the feasibility of coupling electrical impedance tomography (EIT) with models of lung function in order to recover parameters and inform mechanical ventilation control.MethodsA compartmental ordinary differential equation model of lung function is coupled to simulations of EIT, assuming accurate modeling and movement tracking, to generate time series values of bulk conductivity. These values are differentiated and normalized against the total air volume flux to recover regional volumes and flows. These ventilation distributions are used to recover regional resistance and elastance properties of the lung. Linear control theory is used to demonstrate how these parameters may be used to generate a patient-specific pressure mode control.ResultsVentilation distributions are shown to be recoverable, with Euclidean norm errors in air flow below 9% and volume below 3%. The parameters are also shown to be recoverable, although errors are higher for resistance values than elastance. The control constructed is shown to have minimalseminorm resulting in bounded magnitudes and minimal gradients.ConclusionThe recovery of regional ventilation distributions and lung parameters is feasible with the use of EIT. These parameters may then be used in model based control schemes to provide patient-specific care.SignificanceFor pulmonary-intensive-care patients mechanical ventilation is a life saving intervention, requiring careful calibration of pressure settings. Both magnitudes and gradients of pressure can contribute to ventilator induced lung injury. Retrieving regional lung parameters allows the design of patient-specific ventilator controls to reduce injury.