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

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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

SIGNIFICANCE: 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.