SOLVe: a closed-loop system focused on protective mechanical ventilation

• Published in: Biomedical engineering online Vol. 22; no. 1; pp. 47 - 21
• Main Authors: von Platen, Philip, Pickerodt, Philipp A., Russ, Martin, Taher, Mahdi, Hinken, Lea, Braun, Wolfgang, Köbrich, Rainer, Pomprapa, Anake, Francis, Roland C. E., Leonhardt, Steffen, Walter, Marian
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.05.2023; BioMed Central; BMC
• Subjects: Acute respiratory distress syndrome; Animals; Automation; Care and treatment; Closed loop systems; Closed loops; Control algorithms; Customization; Diagnosis; Evidence, Expert; Feedback control; Gas exchange; Lung; Lungs; Mechanical ventilation; Medical research; Medicine, Experimental; Methods; Mortality; Oxygen content; Pandemics; Patient monitoring; Patient outcomes; Patients; Physiological aspects; Physiological closed-loop control; Physiology; Pilot Projects; Positive pressure respiration; Protective ventilation; Respiration; Respiration, Artificial; Respiratory distress syndrome; Respiratory Distress Syndrome - therapy; Tidal Volume - physiology; Ventilation; Ventilators; United Kingdom; Germany; Acute respiratory distress syndrome; Protective ventilation; Physiological closed-loop control
• ISSN: 1475-925X; 1475-925X
• DOI: 10.1186/s12938-023-01111-0

Mechanical ventilation is an essential component in the treatment of patients with acute respiratory distress syndrome. Prompt adaptation of the settings of a ventilator to the variable needs of patients is essential to ensure personalised and protective ventilation. Still, it is challenging and time-consuming for the therapist at the bedside. In addition, general implementation barriers hinder the timely incorporation of new evidence from clinical studies into routine clinical practice. We present a system combing clinical evidence and expert knowledge within a physiological closed-loop control structure for mechanical ventilation. The system includes multiple controllers to support adequate gas exchange while adhering to multiple evidence-based components of lung protective ventilation. We performed a pilot study on three animals with an induced ARDS. The system achieved a time-in-target of over 75 % for all targets and avoided any critical phases of low oxygen saturation, despite provoked disturbances such as disconnections from the ventilator and positional changes of the subject. The presented system can provide personalised and lung-protective ventilation and reduce clinician workload in clinical practice.