title: 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.
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Christian
authors.initials: C
authors.lastname: Brendle
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Mülders
authors.affiliation: Informatik 11, RWTH Aachen University, 52056 Aachen.
authors.forename: Jan
authors.initials: J
authors.lastname: Kühn
authors.affiliation: Department of Intensive Care and Intermediate Care, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Janisch
authors.affiliation: Department of Intensive Care and Intermediate Care, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen.
authors.forename: Rüdger
authors.initials: R
authors.lastname: Kopp
authors.affiliation: Department of Anesthesiology, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074 Aachen.
authors.forename: Rolf
authors.initials: R
authors.lastname: Rossaint
authors.affiliation: Informatik 11, RWTH Aachen University, 52056 Aachen.
authors.forename: Andre
authors.initials: A
authors.lastname: Stollenwerk
authors.affiliation: Informatik 11, RWTH Aachen University, 52056 Aachen.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kowalewski
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Berno
authors.initials: B
authors.lastname: Misgeld
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Steffen
authors.initials: S
authors.lastname: Leonhardt
authors.affiliation: Philips Chair for Medical Information Technology, RWTH Aachen University, 52056 Aachen.
authors.forename: Marian
authors.initials: M
authors.lastname: Walter
mesh_terms: D000818:Animals; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D003198:Computer Simulation; D004867:Equipment Design; D019544:Equipment Failure Analysis; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D025461:Feedback, Physiological; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008954:Models, Biological; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D015656:Respiratory Mechanics; D018511:Systems Integration; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: acute respiratory distress syndrome; extracorporeal membrane oxygenation; gas exchange; lung protection; mechanical ventilation; patient-in-the-loop