Simultaneous Parameter and Input Estimation of a Respiratory Mechanics Model

摘要

Real-time noninvasive estimation of respiratory mechanics in spontaneously breathing patients is still an open problem in the field of critical care. Even assuming that the system is a simplistic first-order single-compartment model, the presence of unmeasured patient effort still makes the problem complex since both the parameters and part of the input are unknown. This paper presents an approach to overcome the underdetermined nature of the mathematical problem by infusing physiological knowledge into the estimation process and using it to construct an optimization problem subject to physiological constraints. As it relies only on measurements available on standard ventilators, namely the flow and pressure at the patient’s airway opening, the approach is noninvasive. Additionally, breath by breath, it continually provides estimates of the patient respiratory resistance and elastance as well as of the muscle effort waveform without requiring maneuvers that would interfere with the desired ventilation pattern.