Control of end-tidal carbon dioxide during phrenic nerve stimulation with mechanical ventilation

IF 4.9 2区医学 Q1 ENGINEERING, BIOMEDICAL

Biomedical Signal Processing and Control Pub Date : 2025-02-12 DOI:10.1016/j.bspc.2025.107649

Arnhold Lohse , Felix Röhren , Philip von Platen , Carl-Friedrich Benner , Dmitrij Ziles , Marius Hühn , Matthias Manfred Deininger , Thomas Breuer , Steffen Leonhardt , Marian Walter

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Abstract

Mechanical ventilation maintains the gas exchange of patients in the intensive care unit which is life-saving, but prolonged ventilation results in diaphragm atrophy. Phrenic nerve stimulation can keep the diaphragm active so that atrophy might be avoided. To use phrenic nerve stimulation in a clinical setting, it is important to implement a closed-loop control system that automatically adjusts stimulation parameters to achieve the desired ventilation. This study presents the development of a robust cascaded control system for end-tidal carbon dioxide using phrenic nerve stimulation. The control system was validated in simulations with 100 virtual patients, in which the conditions of the phrenic nerve stimulation and the patient’s condition changed, as well as in animal trials using pigs. The control system proved to be robust to end-tidal carbon dioxide perturbations, such as changing stimulation efficiency, varying patient conditions, and disconnection, in both simulations and animal trials. Regarding reference tracking, the control system achieved a settling time of 5.5 min–14 min in simulations and of 7.3 min–38.8 min in animal trials. The proposed control system can be used for further development of feedback-controlled phrenic nerve stimulation in the intensive care unit.

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来源期刊

Biomedical Signal Processing and Control 工程技术-工程：生物医学

CiteScore

9.80

自引率

13.70%

发文量

822

审稿时长

4 months

期刊介绍： Biomedical Signal Processing and Control aims to provide a cross-disciplinary international forum for the interchange of information on research in the measurement and analysis of signals and images in clinical medicine and the biological sciences. Emphasis is placed on contributions dealing with the practical, applications-led research on the use of methods and devices in clinical diagnosis, patient monitoring and management. Biomedical Signal Processing and Control reflects the main areas in which these methods are being used and developed at the interface of both engineering and clinical science. The scope of the journal is defined to include relevant review papers, technical notes, short communications and letters. Tutorial papers and special issues will also be published.