Preload-based starling-like control for rotary blood pumps: Numerical comparison with pulsatility control and constant speed operation

Mansouri, M. and Salamonsen, R.F. and Lim, E. and Akmeliawati, R. and Lovell, N.H. (2015) Preload-based starling-like control for rotary blood pumps: Numerical comparison with pulsatility control and constant speed operation. PLoS ONE, 10 (4). p. 16. ISSN 1932-6203

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In this study, we evaluate a preload-based Starling-like controller for implantable rotary blood pumps (IRBPs) using left ventricular end-diastolic pressure (PLVED) as the feedback variable. Simulations are conducted using a validated mathematical model. The controller emulates the response of the natural left ventricle (LV) to changes in PLVED. We report the performance of the preload-based Starling-like controller in comparison with our recently designed pulsatility controller and constant speed operation. In handling the transition from a baseline state to test states, which include vigorous exercise, blood loss and a major reduction in the LV contractility (LVC), the preload controller outperformed pulsatility control and constant speed operation in all three test scenarios. In exercise, preload-control achieved an increase of 54 in mean pump flow ((Q) over bar (P)) with minimum loading on the LV, while pulsatility control achieved only a 5 increase in flow and a decrease in mean pump speed. In a hemorrhage scenario, the preload control maintained the greatest safety margin against LV suction. PLVED for the preload controller was 4.9 mmHg, compared with 0.4 mmHg for the pulsatility controller and 0.2 mmHg for the constant speed mode. This was associated with an adequate mean arterial pressure (MAP) of 84 mmHg. In transition to low LVC, (Q) over bar (P) for preload control remained constant at 5.22 L/min with a PLVED of 8.0 mmHg. With regards to pulsatility control, (Q) over bar (P) fell to the nonviable level of 2.4 L/min with an associated PLVED of 16 mmHg and a MAP of 55 mmHg. Consequently, pulsatility control was deemed inferior to constant speed mode with a PLVED of 11 mmHg and a (Q) over bar (P) of 5.13 L/min in low LVC scenario. We conclude that pulsatility control imposes a danger to the patient in the severely reduced LVC scenario, which can be overcome by using a preload-based Starling-like control approach.

Item Type: Article
Additional Information: ISI Document Delivery No.: CF3VU Times Cited: 0 Cited Reference Count: 45 Cited References: Akimoto T, 1999, ARTIF ORGANS, V23, P797, DOI 10.1046/j.1525-1594.1999.06426.x AlOmari AH, 2011, PHYSIOL MEAS, V32, P1035, DOI 10.1088/0967-3334/32/8/004 AlOmari AH, 2009, PHYSIOL MEAS, V30, P371, DOI 10.1088/0967-3334/30/4/003 AlOmari AHH, 2013, PHYSIOL MEAS, V34, pR1, DOI 10.1088/0967-3334/34/1/R1 Arndt A, 2008, ARTIF ORGANS, V32, P761, DOI 10.1111/j.1525-1594.2008.00628.x Arndt A, 2010, ARTIF ORGANS, V34, P726, DOI 10.1111/j.1525-1594.2010.01092.x Bakouri MA, 2014, ARTIF ORGANS, V38, P587, DOI 10.1111/aor.12223 Bakshi VU, 2007, LINEAR CONTROL SYSTE BERNE RM, 1981, ANNU REV PHYSIOL, V43, P357, DOI 10.1146/ Boston JR, 2003, IEEE ROBOT AUTOM MAG, V10, P54, DOI 10.1109/MRA.2003.1191711 Bullister E, 2002, ARTIF ORGANS, V26, P931, DOI 10.1046/j.1525-1594.2002.07126.x Choi S, 2007, ARTIF ORGANS, V31, P114, DOI 10.1111/j.1525-1594.2007.00350.x Choi S, 2005, INT J CONTROL AUTOM, V3, P100 Endo G, 2002, ASAIO J, V48, P83, DOI 10.1097/00002480-200201000-00016 Esmore DS, 2008, J HEART LUNG TRANSPL, V27, P479, DOI 10.1016/j.healun.2008.02.003 Farrar DJ, 2007, ASAIO J, V53, P310, DOI 10.1097/MAT.0b013e3180536694 Gaddum NR, 2014, ARTIF ORGANS, V38, pE46, DOI 10.1111/aor.12221 Giridharan G, 2005, P AMER CONTR CONF, P3823, DOI 10.1109/ACC.2005.1470570 Giridharan GA, 2002, ARTIF ORGANS, V26, P980, DOI 10.1046/j.1525-1594.2002.07136.x Guyton A. C., 2005, TXB MED PHYSL Guyton AC, 1963, CIRCULATORY PHYSL CA, P237 Haddad F, 2008, CIRCULATION, V117, P1717, DOI 10.1161/CIRCULATIONAHA.107.653584 Jacquet L, 2011, ARTIF ORGANS, V35, P682, DOI 10.1111/j.1525-1594.2011.01227.x Karantonis DM, 2006, ARTIF ORGANS, V30, P671, DOI 10.1111/j.1525-1594.2006.00283.x Konieczny G, 2010, ACTA PHYS POL A, V118, P1183 Letsou GV, 2013, EUR J CARDIO-THORAC, V44, P573, DOI 10.1093/ejcts/ezt106 Lim E, 2012, ARTIF ORGANS, V36, pE125, DOI 10.1111/j.1525-1594.2012.01448.x Lim E, 2012, ARTIF ORGANS, V36, pE110, DOI 10.1111/j.1525-1594.2012.01449.x Lim E, 2015, ARTIF ORGANS, V39, pE24, DOI 10.1111/aor.12370 Lim E, 2010, IEEE T BIO-MED ENG, V57, P254, DOI 10.1109/TBME.2009.2031629 Lim E, 2009, CHARACTERISATION CAR Lim E, 2013, PLOS ONE, V8, DOI 10.1371/journal.pone.0077357 Maeda K, 1998, AM HEART J, V135, P825, DOI 10.1016/S0002-8703(98)70041-9 Mancini D, 1998, CIRCULATION, V98, P1178 Reesink K, 2007, ARTIF ORGANS, V31, P542, DOI 10.4201/j.1525-1594.2007.00420.x Saito I, 2010, P 32 ANN INT C IEEE Salamonsen RF, 2011, ARTIF ORGANS, V35, pE47, DOI 10.1111/j.1525-1594.2010.01168.x Salamonsen RF, 2012, ARTIF ORGANS, V36, P787, DOI 10.1111/j.1525-1594.2012.01457.x Salamonsen RF, 2013, ARTIF ORGANS, V37, P695, DOI 10.1111/aor.12070 Schima H, 2006, J HEART LUNG TRANSPL, V25, P1671 Slaughter MS, 2009, J HEART LUNG TRANSPL, V28, P39, DOI 10.1016/j.healun.2008.10.007 Starling EH, 1927, J PHYSIOL-LONDON, V52, P243 Troughton RW, 2011, J CARDIOVASC TRANSL, V4, P3, DOI 10.1007/s12265-010-9229-z Wu Y, 2003, ARTIF ORGANS, V27, P926, DOI 10.1046/j.1525-1594.2003.00032.x Zhou MD, 2012, BIOMED MICRODEVICES, V14, P235, DOI 10.1007/s10544-011-9601-z Mansouri, Mahdi Salamonsen, Robert F. Lim, Einly Akmeliawati, Rini Lovell, Nigel H. Engineering, Faculty /I-7935-2015 Engineering, Faculty /0000-0002-4848-7052 Australian Research Council Linkages scheme; University of Malaya UM.C/HIR/MOHE/ENG/50 Australian Research Council Linkages scheme and the University of Malaya (UM.C/HIR/MOHE/ENG/50). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. 0 PUBLIC LIBRARY SCIENCE SAN FRANCISCO PLOS ONE
Uncontrolled Keywords: Left-ventricular assist, heart-failure patients, noninvasive estimation, physiological control, hemodynamic-response, device, flow, pressure, exercise, performance.
Subjects: T Technology > T Technology (General)
T Technology > TA Engineering (General). Civil engineering (General)
Divisions: Faculty of Engineering
Depositing User: Mr Jenal S
Date Deposited: 18 Apr 2016 00:46
Last Modified: 05 Jul 2017 01:46

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