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Drug infusion control: An extended direct model reference adaptive control strategy.

机译：药物输注控制：扩展的直接模型参考自适应控制策略。

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摘要

Medicine is one of the fields where control systems has not made significant inroads. The particular challenges of controlling physiological processes, while not insurmountable, are not trivial. Biological systems are highly nonlinear, and there is a significant amount of variability from one patient to another. The same individual can also exhibit different dynamics depending on other factors, such as environmental stresses.; A controller for drug infusion has to be able to achieve good performance for most, if not all, of the potential patient population. These controllers are designed for the general population, as no knowledge is available before hand for each particular patient. This necessitates perforce an algorithm that will be able to compensate for the differences between individuals and external factors. Of the possibilities, direct model reference adaptive control (DMRAC) is the choice for the results presented herein.; Safety and robustness issues must be considered, as a mistake in the infusion of drugs by a controller can be fatal. To this end, constraints must be enforced on drug infusion rates, and the design procedure must guarantee stability.; In this work the DMRAC algorithm is extended to enhance its applicability to drug infusion control. Methods to handle saturation and rate limits are introduced. Additional knowledge of the process is used both in the design procedure, as well as by the controller on-line. A method to relax setpoint constraints is implemented, which allows for performance objectives that are better aligned with the physician's specifications. The performance and stability for systems with time delay is also improved.; Hemodynamic control is the application of choice. The regulation of mean arterial pressure and cardiac output is required under a variety of clinical conditions. Experimental results from work with canines under various situations are presented.; A second application is the regulation of blood glucose. The particular issues involved are explored in detail. Of interest are the glycemic control of diabetic subjects and the treatment of stress hyperglycemia in critically ill patients. Modeling is covered in detail, including subcutaneous insulin infusion and glucose measurements, the carbohydrate metabolism, and glucose absorption from meals.
机译：医学是控制系统尚未取得重大进展的领域之一。控制生理过程的特殊挑战虽然并非不可克服，但并非微不足道。生物系统是高度非线性的，一个病人到另一个病人的变异性很大。同一个人还可以根据其他因素（例如环境压力）表现出不同的动力。对于大多数（即使不是全部）潜在患者群体，输液控制器必须能够实现良好的性能。这些控制器是为一般人群设计的，因为对于每个特定患者而言，他们之前没有任何知识。这需要强制执行一种算法，该算法将能够补偿个人与外部因素之间的差异。其中，直接模型参考自适应控制（DMRAC）是本文介绍的结果的选择。必须考虑安全性和稳健性问题，因为控制器注入药物的错误可能是致命的。为此，必须对药物输注速度施加约束，并且设计程序必须保证稳定性。在这项工作中，DMRAC算法得到了扩展，以增强其在药物输注控制中的适用性。介绍了处理饱和度和速率限制的方法。在设计过程中以及在线控制器中都使用了有关过程的其他知识。实现了一种放松设定值约束的方法，该方法可以使性能目标更好地符合医师的规范。具有时间延迟的系统的性能和稳定性也得到了改善。血液动力学控制是选择的应用。在各种临床条件下均需要调节平均动脉压和心输出量。展示了在各种情况下使用犬类工作的实验结果。第二个应用是血糖调节。将详细探讨涉及的特定问题。感兴趣的是糖尿病患者的血糖控制和危重患者的应激性高血糖症的治疗。详细介绍了建模，包括皮下胰岛素输注和葡萄糖测量，碳水化合物的代谢以及膳食中的葡萄糖吸收。

著录项

  • 作者

    Romanillos Palerm, Cesar Carlos.;

  • 作者单位

    Rensselaer Polytechnic Institute.;

  • 授予单位 Rensselaer Polytechnic Institute.;
  • 学科 Engineering Biomedical.; Engineering Electronics and Electrical.; Health Sciences Pharmacy.
  • 学位 Ph.D.
  • 年度 2003
  • 页码 p.3389
  • 总页数 197
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 生物医学工程;
  • 关键词

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