De-Conflicting Management of Fluid Resuscitation and Medication Infusion
Abstract
The objective of this project is to develop and to conduct in silico and hardware-in-the-loop (HIL) pre-clinical performance testing of a closed-loop control algorithm for de-conflicting management of fluid resuscitation and intravenous drug infusion. The treatment of combat casualties frequently involves infusion of multiple drugs in addition to fluid resuscitation. Simultaneous administrationof fluid and intravenous drugs presents a practical challenge related to the interaction between the two, which in turn may elicit synergistic and/or conflicting clinical effects that lead to challenges associated with the achievement of the desired clinical endpoints as intended by fluid resuscitation and medication infusion. Yet, the vast majority of existing work on closed-loop control of fluidresuscitation and intravenous drug infusion has focused on either fluid resuscitation or intravenous drug infusion alone, while methodologies and algorithms suited to the simultaneous administration of fluid and intravenous drugs have not been rigorously investigated if not unexplored.To address this challenge, we propose to investigate model-based control algorithms applicable to the de-conflicting management of fluid resuscitation and intravenous drug infusion. The approach necessitates a mathematical model to represent the interaction of fluid and intravenous drugs, and a novel closed-loop control algorithm developed based on such a mathematical model. With the support of the ONR~s Young Investigator Program (YIP) Award, we have developed technologies required to achieve the project objective, including (i) physiological modeling of hemodynamic responses to volume perturbation; (ii) pharmacological modeling of intravenous sedative, opioid, and vasopressor drugs; (iii) closed-loop control of fluid resuscitation; and (iv) closed-loop controlof intravenous medication infusion. In this project, we propose to accomplish an array of tasks to achieve the project objective by leveraging our prior success: (i) to develop a mathematical model for the interaction between fluid and intravenous drugs as the basis for the development and testing of closed-loop control algorithms; (ii) to develop a new closed-loop control algorithm for deconflicting management of fluid resuscitation and intravenous medication infusions; and (iii) to perform in silico and HIL pre-clinical performance testing of the closed-loop de-conflicting management algorithm for fluid resuscitation and intravenous medication infusion.This project aims at developing and validating novel technologies to support the automated critical care system (ACCS). Consequently, it is highly relevant to the technological needs of the Navy. Especially, this project may contribute to the Navy in the following aspects: (i) in revolutionizing the quality of combat casualty care by establishing a systematic methodology for de-conflicting management of fluid resuscitation and intravenous medication administration in combat casualties; (ii) in facilitating the regulatory assessment and deployment of automated combat casualty care systems by establishing a systematic methodology for in silico and HIL pre-clinical performance testing of physiological closed-loop controllers applicable to combat casualty care; and (iii) in expediting the future development of closed-loop control algorithms universally applicable to the simultaneous, coordinated, and de-conflicting management of wide-ranging tasks.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jun 13, 2019
- Source ID
- N000141912402
Entities
People
- Jin-Oh Hahn
Organizations
- Office of Naval Research
- United States Navy
- University of Maryland