A real-time expert control strategy for blood gas management in neonates under ventilation treatment

In the therapy of premature infants with respiratory distress syndrome, their arterial oxygen partial pressure is routinely controlled by adjusting the concentration of oxygen (F₁O₂) in the air they inspire. For more severe cases where the patient is unable to breathe unaided, assisted ventilation is introduced to maintain the oxygen supply and carbon dioxide elimination. Multiple ventilator-controlled parameters, including peak inspiratory pressure, positive end-expiratory pressure, ventilation frequency, inspiratory to expiratory duration ratio, may be altered skilfully to optimize gas exchange. Various rules have been derived by paediatritions based on their clinical experiences. In the paper the authors discuss an expert ventilator manager combined with a real-time generalised predictive controller. The objective of the system is to control both blood oxygen and carbon dioxide pressures within their prespecified ranges by adjusting F₁O₂ and four ventilator factors