Closed-Loop Prevention of Hypotension in the Heartbeating Brain-Dead Porcine Model.

Abstract

Objective: The purpose of this paper is to demonstrate feasibility of a novel closed-loop controlled therapy for prevention of hypertension in the heartbeating brain-dead porcine model. Dynamic modeling and system identification were based on in vivo data. A robust controller design was obtained for the identified models. Disturbance attenuation properties and reliability of operation of the resulting control system were evaluated in vivo. The control system responded both predictably and consistently to external disturbances. It was possible to prevent mean arterial pressure to fall below a user-specified reference throughout 24 h of completely autonomous operation. Parameter variability in the identified models confirmed the benefit of closed-loop controlled administration of the proposed therapy. The evaluated robust controller was able to mitigate both process uncertainty and external disturbances. Prevention of hypertension is critical to the care of heartbeating brain-dead organ donors. Its automation would likely increase the fraction of organs suitable for transplantation from this patient group.