Optimal control applied to a thoraco-abdominal CPR model

Eunok Jung, Suzanne Lenhart, Vladimir Protopopescu, Charles Babbs

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

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 languageEnglish
Pages (from-to)157-170
Number of pages14
JournalMathematical Medicine and Biology
Volume25
Issue number2
DOIs
StatePublished - 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

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