SOLVe: a closed-loop system focused on protective mechanical ventilation

BioMedical Engineering OnLine, vol. 22, pp. 47

Abstract

BACKGROUND: Mechanical ventilation is an essential component in the treatment of patients with acute respiratory distress syndrome. Prompt adaptation of the settings of a ventilator to the variable needs of patients is essential to ensure personalised and protective ventilation. Still, it is challenging and time-consuming for the therapist at the bedside. In addition, general implementation barriers hinder the timely incorporation of new evidence from clinical studies into routine clinical practice. RESULTS: We present a system combing clinical evidence and expert knowledge within a physiological closed-loop control structure for mechanical ventilation. The system includes multiple controllers to support adequate gas exchange while adhering to multiple evidence-based components of lung protective ventilation. We performed a pilot study on three animals with an induced ARDS. The system achieved a time-in-target of over 75 % for all targets and avoided any critical phases of low oxygen saturation, despite provoked disturbances such as disconnections from the ventilator and positional changes of the subject. CONCLUSIONS: The presented system can provide personalised and lung-protective ventilation and reduce clinician workload in clinical practice.

Authors 10

1. Philip von Platen corresponding Aachen Chair for Medical Information Technology

   RWTH Aachen University

   Affiliation as printed

   Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany. platen@hia.rwth-aachen.de

   Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany

2. Philipp A. Pickerodt

   Humboldt-Universität zu Berlin · Freie Universität Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of Anesthesiology and Operative Intensive Care Medicine CCM CVK, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany

3. Mahdi Taher

   Humboldt-Universität zu Berlin · Freie Universität Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of Anesthesiology and Operative Intensive Care Medicine CCM CVK, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany

4. Lea Hinken
   Affiliation as printed

   Fritz Stephan GmbH, Gackenbach, Germany

5. Wolfgang Braun
   Affiliation as printed

   Fritz Stephan GmbH, Gackenbach, Germany

6. R. Köbrich
   Affiliation as printed

   EKU Elektronik GmbH, Leiningen, Germany

7. Anake Pomprapa Aachen Chair for Medical Information Technology

   RWTH Aachen University

   Affiliation as printed

   Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany

8. Roland C. E. Francis

   Friedrich-Alexander-Universität Erlangen-Nürnberg · Humboldt-Universität zu Berlin · Universitätsklinikum Erlangen · Freie Universität Berlin · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of Anesthesiology and Operative Intensive Care Medicine CCM CVK, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany

   Department of Anesthesiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Uniklinikum Erlangen, Erlangen, Germany

9. Steffen K. Leonhardt Aachen Chair for Medical Information Technology

   RWTH Aachen University

   Affiliation as printed

   Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany

10. Marian Walter Aachen Chair for Medical Information Technology

    RWTH Aachen University

    Affiliation as printed

    Chair for Medical Information Technology, RWTH Aachen University, Aachen, Germany