Physiological closed-loop control of mechanical ventilation and extracorporeal membrane oxygenation

Abstract

A new concept is presented for cooperative automation of mechanical ventilation and extracorporeal membrane oxygenation (ECMO) therapy for treatment of acute respiratory distress syndrome (ARDS). While mechanical ventilation is continuously optimized to promote lung protection, extracorporeal gas transfer rates are simultaneously adjusted to control oxygen supply and carbon dioxide removal using a robust patient-in-the-loop control system. In addition, the cooperative therapy management uses higher-level algorithms to adjust both therapeutic approaches. The controller synthesis is derived based on the introduced objectives, the experimental setup and the uncertain models. Finally, the autonomous ARDS therapy system capabilities are demonstrated and discussed based on in vivo data from animal experiments.

Keywords: acute respiratory distress syndrome; extracorporeal membrane oxygenation; gas exchange; lung protection; mechanical ventilation; patient-in-the-loop.