Abstract
The techniques of optimal control are applied to a validated blood circulation model of cardiopulmonary resuscitation (CPR), consisting of a system of seven difference equations. In this system, the non-homogeneous forcing terms are chest and abdominal pressures acting as the 'controls'. We seek to maximize the blood flow, as measured by the pressure difference between the thoracic aorta and the right atrium. By applying optimal control methods, we characterize the optimal waveforms for external chest and abdominal compression during cardiac arrest and CPR in terms of the solutions of the circulation model and of the corresponding adjoint system. Numerical results are given for various scenarios. The optimal waveforms confirm the previously discovered positive effects of active decompression and interposed abdominal compression. These waveforms can be implemented with manual (Lifestick-like) and mechanical (vest-like) devices to achieve levels of blood flow substantially higher than those provided by standard CPR, a technique which, despite its long history, is far from optimal.
Original language | English |
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Pages (from-to) | 157-170 |
Number of pages | 14 |
Journal | Mathematical Medicine and Biology |
Volume | 25 |
Issue number | 2 |
DOIs | |
State | Published - Jun 2008 |
Funding
An Oak Ridge National Laboratory seed money grant; the Division of Material Sciences of the U.S. Department of Energy (DE-AC05-00OR22725 to S.L. and V.P.); UT-Battelle, LLC; the Korea Research Foundation Grant, funded by the Korean government (MOEHRD; R08-2003-000-11093-0 to E.J.).
Keywords
- ACD-CPR
- Cardiopulmonary resuscitation
- Difference equation
- IAC-CPR
- Optimal control
- Vest-CPR