Simulator for Simulating and Monitoring the Hypotensive Patients Blood Pressure Response of Phenylephrine Bolus Injection and Infusion with Open-loop and Closed-loop Treatment

Abstract

In this paper, we introduce a model-based simulator for hypotensive patients' blood pressure response to vasopressor drug phenylephrine (PHP) delivery. The simulator is designed based on a model of the mean arterial pressure (MAP) response to PHP infusion. The model is data-driven learning model which is illustrated to be adequately describing inter - and intra patients' response to PHP. In the simulator, besides open loop operation, such as manual PHP bolus injection and continuous infusion, a closed-loop control module is also designed, including an anti-windup PI controller, an adaptive controller and an empirical controller, to regulate the blood pressure at target level and maintain hemodynamic stability in hypotensive patients. In addition, three frequent scenarios happened in clinical treatment are modeled in challenge module. They are sodium nitroprusside (SNP) treatment, baseline pressure drop and hemorrhage. The simulator can be operated with two different interfaces; one is the MPA trend response interface and the other is real-time monitoring interface. The real-time monitoring is real-time synchronization presenting blood pressure waves, heart rate and EtCO2 waves under open and closed-loop treatment. The simulator is capable to train the doctors on the dose of PHP usage for the hypotensive patients with different challenges during the treatment.