Safe Model-Based Multivariable Control of Peritoneal Perfusion

This paper examines the control of abdominal perfusion during medical interventions. The goal is to avoid safety risks such as excessive retained fluid volume, tissue damage/trauma, and intra-abdominal hypertension. The paper presents a perfusion system with peristaltic pumps dictating fluid inflow/outflow rates, and uses model-based control to avoid multiple safety risks simultaneously. Specifically, the paper: (i) introduces a discharge efficiency metric reflecting the risk of tissue trauma and/or outflow cavitation; (ii) identifies a dynamic model of discharge efficiency from animal test data; and, (iii) develops a safe perfusion control algorithm based on this model. The algorithm receives three user inputs: a desired inflow rate, a desired perfused volume, and a safety bound on discharge efficiency. The algorithm minimizes the deviation of the commanded inflow/outflow rates from a nonlinear model reference controller, subject to a barrier constraint on discharge efficiency. This furnishes a switching control structure providing convergence to the desired perfusion settings in the absence of outflow occlusion, and operating safely when outflow is occluded, as shown in simulation-based validation studies. Copyright (c) 2023 The Authors. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/)