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首页> 外文会议>Annual Rocky Mountain Bioengineering Symposium >A closed-loop controller for mechanical ventilation of patients with ARDS
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A closed-loop controller for mechanical ventilation of patients with ARDS

机译：用于ARDS患者机械通风的闭环控制器

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Mechanical ventilators are routinely used to care for patients who cannot adequately breath on their own. Management of mechanical ventilation often involves a careful watch of the patient's arterial blood-oxygen tension and requires frequent adjustment of ventilation parameters to optimize the therapy. This situation lends itself as a candidate for closed-loop control. This report describes a closed-loop control system based on well-established protocols to systematically maintain appropriate levels of positive end-expiratory pressure (PEEP) and inspired oxygen (FiO2) in patients with Adult Respiratory Distress Syndrome (ARDS). The closed-loop control system consists of an in-dwelling arterial oxygenation (PaO2) sensor (Pfizer Continucath), coupled to a Macintosh computer that continuously controls FiO2 and PEEP settings on a Hamilton Amadeus ventilator. The implemented protocols provide continuous closed-loop control of oxygenation and a balance between patient need and minimal therapy. The controller is based on a traditional proportional-integral-derivative (PID) approach. The idea is to control, or maintain, the patient's PaO2 level at a target value determined, or set, by the patient's physician. The controller also features non-linear and adaptive characteristics that allow the system to respond more aggressively to "threatening" levels of PaO2. Another benefit of the control system is the ability to display, monitor, record and store all system parameters, settings, and control variables for future analysis and study. The system was extensively tested in the laboratory and in animal trials prior to use on human subjects. The results of a small clinical trial indicated that the system maintained control of the patient's therapy nearly 84% of the time. During the remainder of this time, the controller was interrupted primarily for suctioning, PaO2 sensor calibration or replacement. The response of the closed-loop controller was found to be appropriate, reliable and safe in patients with ARDS.
机译：机械呼吸机通常用于照顾不能自行充分呼吸的患者。机械通气的管理通常涉及仔细观察患者的动脉血氧张力，并且需要频繁地调整通风参数以优化治疗。这种情况使自己作为闭环控制的候选者。本报告描述了一种基于良好的协议的闭环控制系统，以系统地维持成人呼吸窘迫综合征（ARDS）患者的适当水平的正末期呼气压力（PEEP）和启发氧气（FIO2）。闭环控制系统由内插动脉氧合（PEAD2）传感器（PFizer Continucath）组成，耦合到Macintosh计算机，该计算机连续控制汉密尔顿Amadeus呼吸机上的Fio2和Peep设置。所实施的方案提供氧合的连续闭环控制和患者需要和最小疗法之间的平衡。控制器基于传统的比例积分衍生物（PID）方法。该想法是在患者的医生确定或设定的目标值下控制或维护患者的PAO2水平。控制器还具有非线性和自适应特性，使系统能够更积极地响应“威胁”PAO2的水平。控制系统的另一个好处是能够显示，监控，记录和存储所有系统参数，设置和控制变量以供未来的分析和研究。在对人类受试者使用之前，该系统在实验室和动物试验中进行了广泛测试。小临床试验的结果表明，该系统保持了患者治疗的控制近84％的时间。在此时间的剩余时间内，控制器被中断，主要用于吸入，PAO2传感器校准或更换。发现闭环控制器的响应是适当，可靠和安全的ARDS患者。

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