Nicoleta E. Badau

Hemodynamic management is extremely important in cardiac patients undergoing surgery. Traditionally, the approach towards hemodynamic stabilization included the control of both mean arterial pressure (MAP) and cardiac output (CO) using Sodium Nitroprusside and Dopamine. More efficient and safer drugs have been introduced, such as Norepinephrine. The focus of this manuscript is to provide some preliminary results regarding the closed loop control of MAP using Norepinephrine. However, to design a dedicated control system, a mathematical model describing the effect of Norepinephrine on mean arterial pressure is required. Only a handful of papers describe a pharmacokinetic–pharmacodynamic (PK-PD) model. In this paper, a simplified model suitable for designing a controller is determined based on PK-PD insights and existing clinical data. Existing closed loop controllers are based on the simple proportional integral derivative (PID) controller, with limited robustness to patient variability. In this paper, two advanced control strategies are proposed to replace PID. The closed loop simulation results include reference tracking and disturbance rejection and show the efficiency and robustness of the proposed control algorithms. The preliminary results set the background for further research in this area.

Automatic control in biomedicine has attracted the attention of clinicians to mitigate the side effects resulting from drug overdoses administered to patients. To provide the most optimal and accurate results, the computer-controlled systems in biomedical engineering require more advanced tuning procedures that tackle patient variability and ensure the robustness of the control system. This has been enhanced over the past two decades through the replacement of standard PID controllers with fractional-order controllers. However, most of the developed fractional-order control methods address only the robustness with respect to gain variations. In this study, a novel fractional-order control algorithm that is robust to time constant variations is developed. The control algorithm is designed for second-order plus dead time systems. A graphical solution is chosen to solve the nonlinear system of equations for the proposed approach. Three biomedical applications are employed as case studies. The first one consists in the control of the bispectral index in general anesthesia, the second one refers to the blood glucose level control for diabetic patients, and finally, the third one tackles computerized control in chemotherapy. The closed-loop simulation results validate the efficiency of the tuning method according to the accepted values of the performance specifications in the scientific literature.

The research field of clinical practice has experienced a substantial increase in the integration of information technology and control engineering, which includes the management of medication administration for general anaesthesia. The invasive nature of input signals is the reason why autotuning methods are not widely used in this research field. This study proposes a non-invasive method using small-amplitude sine tests to estimate patient parameters, which allows the design of a personalised controller using an autotuning principle. The primary objective is to regulate the Bispectral Index through the administration of Propofol during the maintenance phase of anaesthesia, using a personalised fractional-order PID. This work aims to demonstrate the effectiveness of personalised control, which is facilitated by the proposed sine-based method. The closed-loop simulation results demonstrate the efficiency of the proposed approach.