Contact persons

• Philip von Platen, M.Sc.
• Arnhold Lohse, M.Sc.

Project description

Patients with Acute Lung Injury (ALI) or Acute Respiratory Distress Syndrome (ARDS) experience a partial lung collapse (atelectasis) leading to an impaired gas exchange. The patient's oxygen supply is reduced and the removal of carbon dioxide becomes more difficult. The standard therapy involves artificial ventilation of the patient with an increased fraction of inspired oxygen and monitoring of physiological parameters, such as blood pressure, pulse and oxygen saturation. However, mechanical ventilation introduces shear stresses between atelectatic and non-atelectatic areas. This may lead to a severe damage of lung tissue (Ventilator Induced Lung Injury, VILI).

The so-called "Open Lung Concept" (OLC) reduces VILI by initially opening the lung with the help of recruitment maneuvers and by keeping it open with adequate positive end-expiratory pressures. Via the measurement of the blood gas concentrations, the status of the lung (open vs. closed) can be determined. As the status of the lung is unstable and changes over time, recruitment maneuvers have to be repeated and the lung constantly be monitored which calls for an automated approach.

Project goals

1. Development of an automated ventilation system that can execute the OLC or other complex ventilation strategies through closed-loop control based on medical expertise (Fig. 1+2).
2. System integration of thoracic Electrical Impedance Tomography (EIT), a technique that is capable of displaying changes of the conductivity distribution along a horizontal body cross section (Fig. 3). This information can be used for the evaluation of the regional distribution of ventilation.

Project partners

• University Medical Center Schleswig-Holstein, Campus Lübeck
• Erasmus University, Rotterdam, Netherlands
• Charité Berlin, Berlin

Publications

• Pomprapa A  et al, "Self-Tuning Adaptive Control of the Arterial Oxygen Saturation for Automated ‘Open Lung’ Maneuvers", 3. Dresdner Medizintechnik-Symposium, Dresden, 2010
• Luepschen H. et al, "Enhancement of Protective Ventilation Strategies Using Electrical Impedance Tomography", IFMBE Proc. 14, 2006
• Luepschen H. et al, "Anwendungspotential der thorakalen elektrischen Impedanztomographie", Technische Mitteilungen 99 (2006), Heft 1/2.
• Luepschen H. et al, "Modelling of the Electric Potential Distribution in a Thorax Phantom for Electrical Impedanz Tomography Using the Finite Element Method", IEE Proceedings of the 6th International Conference on Computational Electromagnetics - CEM 2006
• Luepschen H. et al, "Optimization of Artificial Ventilation Therapy for ARDS based on Automatic Identification of Lung Properties", IFBME Proc. 11(1), 2005
• Luepschen H. et al, "Clinical Applications of Thoracic Electrical Impedance Tomography", Proc. of 6th Conference on Biomedical Applications of Electrical Impedance Tomography, London, UK, June 22-24, 2005
• Pomprapa A., et al., "Supervisory mechanism for oscillatory suppression in automatic ventilation therapy based on the ARDSNet protocol", Automatisierungstechnische Verfahren für die Medizin (AUTOMED 2016), Wismar, 2016
• Pomprapa A., et al., "Minimal arterial blood gas analysis based on the average carbon dioxide elimination during automatic ventilation therapy using the ARDSNet protocol", European Society of Intensive Care Medicine (LIVES 2016 - ESICM), Milan, 2016
• Pomprapa A., et al., "Artificial intelligence of closed-loop ventilation therapy with hemodynamic control using open lung concept", International Journal of Intelligent Computing and Cybernetics, vol. 8, iss. 1, pp. 50-68, 2015
• Pomprapa A., et al., "Evaluation of regional ventilation during automatic ventilation therapies based on differential functional EIT images", The 16th International Conference on Biomedical Applications of Electrical Impedance Tomography, Neuchâtel, 2015
• Pomprapa A., et al., "Automated respiratory therapy system based on the ARDSNet protocol with systemic perfusion control", Current Directions in Biomedical Engineering, 1 (1), pp. 314-317, 2015
• Pomprapa A., et al., "Automatic protective ventilation using the ARDSNet protocol with the additional monitoring of electrical impedance tomography", Critical Care; 18:R128, 2014
• Pomprapa A., et al., "Computerized ventilation therapy with automatizing Noradrenaline dose using state-of-the-art Open Lung Management®", 2nd Russian German Conference on biomedical engineering, Saint Petersburg, 2014
• Pomprapa A., et al., "Comparison between open lung management and autoARDSnet protocol for long-term ventilation therapy using electrical impedance tomography", XVth International Conference on Electrical Bio-Impedance (ICEBI) and XIVth Conference on Electrical Impedance Tomography (EIT), Heilbad-Heiligenstadt,2013
• Pomprapa A., et al., "Artificial intelligence in automatic ventilation therapy using open lung concept", The 7th International Conference on Software, Knowledge, Information Management and Applications (SKIMA 2013), Chiang Mai, 2013
• Pomprapa A., et al., "A comparison of a fully automatic ARDSnet protocol and a feedback-controlled Open Lung Management concept", The 33rd International Symposium on Intensive Care and Emergency Medicine (ISICEM 2013), Brussels, 2013
• Pomprapa A., et al., "Closed-loop ventilation of oxygenation and end-tidal CO2", IEEE SMC 2013, 2013
• Pomprapa A., et al., "Automatisiertes ARDSnet Protokoll für die Closed-Loop Ventilation mit EIT Bewertung", Automatisierungstechnische Verfahren für die Medizin, 10. Workshop AUTOMED 2012, 2012
• Pomprapa A., et al., "Fuzzy Control of Tidal Volume for ARDS Patients in Closed-Loop Ventilation", 22nd Annual Meeting of the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC 2011), Erlangen, 2011