A novel adaptive control system for noisy pressure-controlled ventilation: a numerical simulation and bench test study

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

PURPOSE: There is growing interest in the use of both variable and pressure-controlled ventilation (PCV). The combination of these approaches as "noisy PCV" requires adaptation of the mechanical ventilator to the respiratory system mechanics. Thus, we developed and evaluated a new control system based on the least-mean-squares adaptive approach, which automatically and continuously adjusts the driving pressure during PCV to achieve the desired variability pattern of tidal volume (V (T)).

METHODS: The controller was tested during numerical simulations and with a physical model reproducing the mechanical properties of the respiratory system. We applied step changes in respiratory system mechanics and mechanical ventilation settings. The time needed to converge to the desired V (T) variability pattern after each change (t (c)) and the difference in minute ventilation between the measured and target pattern of V (T) (DeltaMV) were determined.

RESULTS: During numerical simulations, the control system for noisy PCV achieved the desired variable V (T) pattern in less than 30 respiratory cycles, with limited influence of the dynamic elastance (E*) on t (c), except when E* was underestimated by >25%. We also found that, during tests in the physical model, the control system converged in <60 respiratory cycles and was not influenced by airways resistance. In all measurements, the absolute value of DeltaMV was <25%.

CONCLUSION: The new control system for noisy PCV can prove useful for controlled mechanical ventilation in the intensive care unit.

Details

OriginalspracheEnglisch
Seiten (von - bis)164-168
Seitenumfang5
FachzeitschriftIntensive Care Medicine
Jahrgang36
Ausgabenummer1
PublikationsstatusVeröffentlicht - Jan. 2010
Peer-Review-StatusJa

Externe IDs

researchoutputwizard legacy.publication#35360
Scopus 76549131502
PubMed 19779696
ORCID /0000-0003-0554-2178/work/142249762
ORCID /0000-0003-3953-3253/work/142251736

Schlagworte

Schlagwörter

  • Acute Lung Injury/therapy, Benchmarking/methods, Computer Simulation, Humans, Lung Compliance, Noise/adverse effects, Pressure, Respiration, Artificial, Respiratory Mechanics/physiology