Closed-loop controller for chest compressions based on coronary perfusion pressure: a computer simulation study

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• 作者：Chunfei Wang ; Guang Zhang ; Taihu Wu…
• 关键词：Chest compression ; Computer simulation ; Fuzzy control ; Coronary perfusion pressure
• 刊名：Medical and Biological Engineering and Computing
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：54
• 期：2-3
• 页码：273-281
• 全文大小：1,332 KB
• 参考文献：1.Ang KH, Chong GCY, Li Y (2005) PID control system analysis, design, and technology. IEEE Trans Control Syst Technol 13(4):559–576CrossRef
  2.Babbs CF (1999) CPR techniques that combine chest and abdominal compression and decompression. Circulation 100:2146CrossRef PubMed
  3.Babbs CF (2005) Effects of an impedance threshold valve upon hemodynamic in Standard CPR: studies in a refined computational model. Resuscitation 66:335CrossRef PubMed
  4.Babbs CF (2006) Design of near-optimal waveforms for chest and abdominal compression and decompression in CPR using computer simulated evolution. Resuscitation 68:277CrossRef PubMed
  5.Babbs CF, Voorhees WD, Fitzgerald KR, Holmes HR, Geddes LA (1983) Relationship of blood pressure and flow during CPR to chest compression amplitude: evidence for an effective compression threshold. Ann Emerg Med 12:527CrossRef PubMed
  6.Brekhovskikh LM, Goncharov V (1994) Mechanics of continua and wave dynamics. Springer, BerlinCrossRef
  7.Callaham M, Barton C, Matthay M (1992) Effect of epinephrine on the ability of end-tidal carbon dioxide readings to predict initial resuscitation from cardiac arrest. Crit Care Med 20(3):337–343CrossRef PubMed
  8.Cohen TJ, Tucker KJ, Redberg RF, Lurie KG, Chin MC, Dutton JP et al (1992) Active compression–decompression resuscitation: a novel method of cardiopulmonary resuscitation. Am Heart J 124:1145CrossRef PubMed
  9.Fenely MP, Maier GW, Kern KB, Gaynor JW, Gall SA, Sanders AB et al (1988) Influence of compression rate on initial success of resuscitation and 24 h survival after prolonged manual cardiopulmonary resuscitation in dogs. Circulation 77:240CrossRef
  10.Georgiou M, Papathanassoglou E, Xanthos T (2014) Systematic review of the mechanisms driving effective blood flow during adult CPR. Resuscitation 85(11):1586–1593CrossRef PubMed
  11.Gerla G (2005) Fuzzy logic programming and fuzzy control. Stud Log 79:231–254CrossRef
  12.Halperin HR, Tsitlik JE, Gelfand M, Weisfeldt ML, Gruben KG, Levin HR, Rayburn BK, Chandra NC, Scott CJ, Kreps BJ, Siu CO, Guerci AD (1993) A preliminary study of cardiopulmonary resuscitation by circumferential compression of the chest with use of a pneumatic vest. N Engl J Med 329:762CrossRef PubMed
  13.Hoke RS, Chamberlain D (2004) Skeletal chest injuries secondary to cardiopulmonary resuscitation. Resuscitation 63(3):327–338CrossRef PubMed
  14.Kern KB (2000) Coronary perfusion pressure during cardiopulmonary resuscitation. Best Pract Res Clin Anaesthesiol 14:591CrossRef
  15.Kern KB, Ewy GA, Voorhees WD, Babbs CF, Tacker WA (1988) Myocardial perfusion pressure: a predictor of 24-hour survival during prolonged cardiac arrest in dogs. Resuscitation 16:241CrossRef PubMed
  16.Lindner KH, Prengel AW, Pfenninger EG, Lindner IM, Strohmenger HU, Georgieff M, Lurie KG (1995) Vasopressin improves vital organ blood flow during closed-chest cardiopulmonary resuscitation in pigs. Circulation 91:215CrossRef PubMed
  17.Little CM, Angelos MG, Paradis NA (2003) Compared to angiotensin II, epinephrine is associated with high myocardial blood flow following return of spontaneous circulation after cardiac arrest. Resuscitation 59:353CrossRef PubMed
  18.Martin GB, Gentile NT, Paradis NA, Moeggenberg J, Appleton TJ, Nowak RM (1990) Effect of epinephrine on end-tidal carbon dioxide monitoring during CPR. Ann Emerg Med 19(4):396–398CrossRef PubMed
  19.Neumar RW, Otto CW, Link MS et al (2010) Part 8—adult advanced cardiovascular life support: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science. Circulation 122:S729CrossRef PubMed
  20.Niemann JT, Criley JM, Rosborough JP, Niskanen RA, Alferness C (1985) Predictive indices of successful cardiac resuscitation after prolonged arrest and experimental cardiopulmonary resuscitation. Ann Emerg Med 14:521CrossRef PubMed
  21.Otlewski MP, Geddes LA, Pargett M, Babbs CF (2009) Methods for calculating coronary perfusion pressure during CPR. Cardiovasc Eng 9:98CrossRef PubMed
  22.Paradis NA, Martin GB, Rivers EP, Goetting MG, Appleton TJ, Feingold M, Nowak RM (1990) Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA 263:1106CrossRef PubMed
  23.Sanders AB, Ewy GA, Bragg S, Atlas M, Kern KB (1985) Expired PCO2 as a prognostic indicator of successful resuscitation from cardiac arrest. Ann Emerg Med 14(10):948–952CrossRef PubMed
  24.Sanders AB, Atlas M, Ewy GA, Kern KB, Bragg S (1985) Expired PCO2 as an index of coronary perfusion pressure. Am J Emerg Med 3(2):147–149CrossRef PubMed
  25.Steen S, Liao Q, Pierre L, Paskevicius A, Sjöberg T (2002) Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation 55:285CrossRef PubMed
  26.Varon J, Marik PE, Fromm RE (1998) Cardiopulmonary resuscitation: a review for clinicians. Resuscitation 36:133CrossRef PubMed
  27.Wik L, Bircher NG, Safar P (1996) A comparison of prolonged manual and mechanical external chest compression after cardiac arrest in dogs. Resuscitation 32:241CrossRef PubMed
  28.Yannopoulos D, McKnite S, Aufderheide TP, Sigurdsson G, Pirrallo RG, Benditt D, Lurie KG (2005) Effects of incomplete chest wall decompression during cardiopulmonary resuscitation on coronary and cerebral perfusion pressures in a porcine model of cardiac arrest. Resuscitation 64:363CrossRef PubMed
  29.Zhang G, Zheng JW, Wu J, Wu TH (2012) An optimal closed-loop control strategy for mechanical chest compression devices: a trade-off between the risk of chest injury and the benefit of enhanced blood flow. Comput Methods Programs Biomed 108(1):288–298CrossRef PubMed
  30.Zhang G, Zheng J, Zhao P et al (2012) Computer simulation study of chest compression physiological feedback parameters. J Biomed Eng 29:1032
  31.Zhang G, Zheng J, Zhao P, Wang Y, Qian S, Lu H, Wu T (2012) Computer simulation study on physiological feedback parameters during chest compression. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 29(6):1032–1040PubMed
  
• 作者单位：Chunfei Wang (1)
  Guang Zhang (1)
  Taihu Wu (1)
  Ningbo Zhan (2)
  Yaling Wang (1)
  
  1. Institute of Medical Equipment, Academy of Military Medical Science, Tianjin, China
  2. Department of Medical Instrument, NO.302 Hospital, Beijing, China
  
• 刊物类别：Engineering
• 刊物主题：Biomedical Engineering
  Human Physiology
  Imaging and Radiology
  Computer Applications
  Neurosciences
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1741-0444

文摘

High-quality cardiopulmonary resuscitation contributes to cardiac arrest survival. The traditional chest compression (CC) standard, which neglects individual differences, uses unified standards for compression depth and compression rate in practice. In this study, an effective and personalized CC method for automatic mechanical compression devices is provided. We rebuild Charles F. Babbs’ human circulation model with a coronary perfusion pressure (CPP) simulation module and propose a closed-loop controller based on a fuzzy control algorithm for CCs, which adjusts the CC depth according to the CPP. Compared with a traditional proportion–integration–differentiation (PID) controller, the performance of the fuzzy controller is evaluated in computer simulation studies. The simulation results demonstrate that the fuzzy closed-loop controller results in shorter regulation time, fewer oscillations and smaller overshoot than traditional PID controllers and outperforms the traditional PID controller for CPP regulation and maintenance.