Closed-loop regulation of arterial pressure after acute brain death.
The purpose of this concept study was to investigate the possibility of automatic mean arterial pressure (MAP) regulation in a porcine heart-beating brain death (BD) model. Hemodynamic stability of BD donors is necessary for maintaining acceptable quality of donated organs for transplantation. Manua...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 32; no. 3; pp. 429 - 438 |
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| Autores principales: | , , , , , , , , |
| Formato: | equations & formulas pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129595132&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129595132 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Jun2018 vid: 32 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 129595132 129595132 NLM28602010 129595132 10.1007/s10877-017-0033-z NLM28602010 129595132 ppf: 429 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Closed-loop regulation of arterial pressure after acute brain death. aug: au: Soltesz, Kristian Sjöberg, Trygve Jansson, Tomas Johansson, Rolf Robertsson, Anders Paskevicius, Audrius Liao, Quiming Qin, Guangqi Steen, Stig affil: Department Automatic Control, Lund University, P.O. Box 118, SE-221 00, Lund, Sweden sug: subj: Arterial Pressure Monitoring, Physiologic Methods Brain Death Anesthesia, Inhalation Methods Monitoring, Physiologic Equipment and Supplies Hemodynamics Models, Biological Swine Hypertension Hypotension Animal Studies Blood Gas Analysis Myocardial Contraction Funding Source ab: The purpose of this concept study was to investigate the possibility of automatic mean arterial pressure (MAP) regulation in a porcine heart-beating brain death (BD) model. Hemodynamic stability of BD donors is necessary for maintaining acceptable quality of donated organs for transplantation. Manual stabilization is challenging, due to the lack of vasomotor function in BD donors. Closed-loop stabilization therefore has the potential of increasing availability of acceptable donor organs, and serves to indicate feasibility within less demanding patient groups. A dynamic model of nitroglycerine pharmacology, suitable for controller synthesis, was identified from an experiment involving an anesthetized pig, using a gradient-based output error method. The model was used to synthesize a robust PID controller for hypertension prevention, evaluated in a second experiment, on a second, brain dead, pig. Hypotension was simultaneously prevented using closed-loop controlled infusion of noradrenaline, by means of a previously published controller. A linear model of low order, with variable (uncertain) gain, was sufficient to describe the dynamics to be controlled. The robustly tuned PID controller utilized in the second experiment kept the MAP within a user-defined range. The system was able to prevent hypertension, exceeding a reference of 100 mmHg by more than 10%, during 98% of a 12 h experiment. This early work demonstrates feasibility of the investigated modelling and control synthesis approach, for the purpose of maintaining normotension in a porcine BD model. There remains a need to characterize individual variability, in order to ensure robust performance over the expected population. pubtype: Academic Journal doctype: equations & formulas pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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