PREVENTING VENTILATOR-ASSOCIATED LUNG INJURY USING FEEDBACK CONTROL ENGINEERING

Lead Research Organisation: University of Nottingham
Department Name: School of Medicine

Abstract

This project will develop a multi-compartmental, multi-scalar, mathematical model of alveolar ventilation dynamics (which includes gas exchange, dynamic and non-linear alveolar compliance and bronchial resistance), cardiovascular performance and blood (with reference to its gas-carrying abilities). The developed model will be used to elucidate the extent and distribution of the factors causative of lung injury in diseased, heterogeneous, mechanically-ventilated lungs. By treating the problem as one of feedback control, we will investigate methods of parameter adjustment in the mechanical ventilator to optimise cardiac output and arterial gas tensions while minimising the factors associated with VALI. Due to the inevitable complexity of the simulation model which we intend to develop, advanced methods from multivariable robust and optimal control theory will be required in order to identify which combinations of parameters should be adjusted, and how, in order to achieve the desired reduction in VALI. The work will go beyond that previously attempted in quantifying the factors that risk lung injury during mechanical ventilation through the greater fidelity of the proposed simulation platform. In addition, we will apply robustness analysis techniques to the modelling to improve the reliability and applicability of our findings. This will allow us to perform population modelling, rather than the commonly used approach of modelling and studying a single, idealized subject, rendering our findings applicable to populations and to a variety of real patients, in contrast to previous work where the idealized subject is in fact representative of neither the population nor any one individual.
 
Description We have demonstrated that lung injury, which occurs during during mechanical ventilation in critically ill patients, is associated with specific patterns of lung inflation and deflation. We have demonstrated optimal methods of maintaining the "open lung" (i.e. preventing collapse of the microscopic air sacs).
Exploitation Route The findings already influence policy and practice in intensive care units. Subsequent work will aim to personalise treatments for individual patients.
Sectors Healthcare

 
Description Healthcare Impact Partnerships
Amount £866 (GBP)
Funding ID EP/P023444/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Academic/University
Country United Kingdom
Start 06/2017 
End 05/2020
 
Description MRC Cardiovascular Group
Amount £170,000 (GBP)
Funding ID G1002017 
Organisation Medical Research Council (MRC) 
Department MRC Cardiovascular Group
Sector Public
Country United Kingdom
Start 05/2011 
End 04/2012
 
Description MRC Cardiovascular Group
Amount £170,000 (GBP)
Funding ID G1002017 
Organisation Medical Research Council (MRC) 
Department MRC Cardiovascular Group
Sector Public
Country United Kingdom
Start 05/2011 
End 04/2012
 
Description Modelling research group 
Organisation University of Exeter
Department Centre for Systems, Dynamics and Control
Country United Kingdom 
Sector Academic/University 
PI Contribution My team (Nottingham) provides medical and physiological expertise, along with design of models.
Collaborator Contribution Declan Bates' team (Exeter) provides engineering and computational expertise, particular in validation & verification of models.
Impact Several research manuscripts, employed post-doctoral staff and successful grant applications.
Start Year 2006
 
Description Modelling research group 
Organisation University of Warwick
Department School of Engineering
Country United Kingdom 
Sector Academic/University 
PI Contribution My team (Nottingham) provides medical and physiological expertise, along with design of models.
Collaborator Contribution Declan Bates' team (Exeter) provides engineering and computational expertise, particular in validation & verification of models.
Impact Several research manuscripts, employed post-doctoral staff and successful grant applications.
Start Year 2006