Dataset Information

Evaluation of Fluid Resuscitation Control Algorithms via a Hardware-in-the-Loop Test Bed.

ABSTRACT:

Objective

This paper presents a hardware-in-the-loop (HIL) testing platform for evaluating the performance of fluid resuscitation control algorithms. The proposed platform is a cyber-physical system that integrates physical devices with computational models and computer-based algorithms.

Methods

The HIL test bed is evaluated against in silico and in vivo data to ensure the hemodynamic variables are appropriately predicted in the proposed platform. The test bed is then used to investigate the performance of two fluid resuscitation control algorithms: a decision table (rule-based) and a proportional-integral-derivative (PID) controller.

Results

The statistical evaluation of test bed indicates that similar results are observed in the HIL test bed, in silico implementation, and the in vivo data, verifying that the HIL test bed can adequately predict the hemodynamic responses. Comparison of the two fluid resuscitation controllers reveals that both controllers stabilized hemodynamic variables over time and had similar speed to efficiently achieve the target level of the hemodynamic endpoint. However, the accuracy of the PID controller was higher than the rule-based for the scenarios tested in the HIL platform.

Conclusion

The results demonstrate the potential of the HIL test bed for realistic testing of physiologic controllers by incorporating physical devices with computational models of physiology and disturbances.

Significance

This type of testing enables relatively fast evaluation of physiologic closed-loop control systems to aid in iterative design processes and offers complementary means to existing techniques (e.g., in silico, in vivo, and clinical studies) for testing of such systems against a wide range of disturbances and scenarios.

SUBMITTER: Mirinejad H

PROVIDER: S-EPMC7082848 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Evaluation of Fluid Resuscitation Control Algorithms via a Hardware-in-the-Loop Test Bed.

Mirinejad Hossein H Parvinian Bahram B Ricks Margo M Zhang Yi Y Weininger Sandy S Hahn Jin-Oh JO Scully Christopher G CG

IEEE transactions on bio-medical engineering 20190508 2

<h4>Objective</h4>This paper presents a hardware-in-the-loop (HIL) testing platform for evaluating the performance of fluid resuscitation control algorithms. The proposed platform is a cyber-physical system that integrates physical devices with computational models and computer-based algorithms.<h4>Methods</h4>The HIL test bed is evaluated against in silico and in vivo data to ensure the hemodynamic variables are appropriately predicted in the proposed platform. The test bed is then used to inve ...[more]

PMID: 31071014

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Project description:ObjectivesRapid fluid resuscitation has become standard in sepsis care, despite "low-quality" evidence and absence of guidelines for populations "at risk" for volume overload. Our objectives include as follows: 1) identify predictors of reaching a 30 mL/kg crystalloid bolus within 3 hours of sepsis onset (30by3); 2) assess the impact of 30by3 and fluid dosing on clinical outcomes; 3) examine differences in perceived "at-risk" volume-sensitive populations, including end-stage renal disease, heart failure, obesity, advanced age, or with documentation of volume "overload" by bedside examination.DesignRetrospective cohort study. All outcome analyses controlled for sex, end-stage renal disease, heart failure, sepsis severity (severe sepsis vs septic shock), obesity, Mortality in Emergency Department Sepsis score, and time to antibiotics.SettingUrban, tertiary care center between January 1, 2014, and May 31, 2017.PatientsEmergency Department treated adults (age ≥18 yr; n = 1,032) with severe sepsis or septic shock.InterventionsAdministration of IV fluids by bolus.Measurements and main resultsIn total, 509 patients received 30by3 (49.3%). Overall mortality was 17.1% (n = 176), with 20.4% mortality in the shock group. Patients who were elderly (odds ratio, 0.62; 95% CI, 0.46-0.83), male (odds ratio, 0.66; CI, 0.49-0.87), obese (odds ratio, 0.18; CI, 0.13-0.25), or with end-stage renal disease (odds ratio, 0.23; CI, 0.13-0.40), heart failure (odds ratio, 0.42; CI, 0.29-0.60), or documented volume "overload" (odds ratio, 0.30; CI, 0.20-0.45) were less likely to achieve 30by3. Failure to meet 30by3 had increased odds of mortality (odds ratio, 1.52; CI, 1.03-2.24), delayed hypotension (odds ratio, 1.42; CI, 1.02-1.99), and increased ICU stay (~2 d) (β = 2.0; CI, 0.5-3.6), without differential effects for "at-risk" groups. Higher fluid volumes administered by 3 hours correlated with decreased mortality, with a plateau effect between 35 and 45 mL/kg (p < 0.05).ConclusionsFailure to reach 30by3 was associated with increased odds of in-hospital mortality, irrespective of comorbidities. Predictors of inadequate resuscitation can be identified, potentially leading to interventions to improve survival. These findings are retrospective and require future validation.

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Dataset Information

Evaluation of Fluid Resuscitation Control Algorithms via a Hardware-in-the-Loop Test Bed.

Objective

Methods

Results

Conclusion

Significance

Publications

Evaluation of Fluid Resuscitation Control Algorithms via a Hardware-in-the-Loop Test Bed.

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