|
Claims  |
|
|
What is claimed is:
1. A method for controlling a process to obtain a specified output,
O.sub.s, where the process is described by a linear model that defines an
output of the process as a function of a specified control signal, wherein
the control signal controls an actuator that affects the process, said
method comprising the steps of:
(a) arbitrarily selecting a first value, X.sub.1, and a second value,
X.sub.2, for the control signal, and initializing a plurality of state
variables in the model;
(b) as a function of the first and second values of the control signal,
which are respectively input to the model, determining corresponding first
and second output values, O.sub.1 and O.sub.2, that would be obtained at
the end of an interval of time, .DELTA.t, were the control signal to be
applied for this interval;
(c) interpolating with respect to the first and second values of the
control signal and corresponding first and second output values to
determine a desired value, X.sub.d, for the control signal that should
produce the specified output, O.sub.s, at the end of the time interval,
.DELTA.t;
(d) for the time interval, .DELTA.t, operating the process using the
desired value, X.sub.d, determined in step (c) for the control signal;
(e) determining a value, X.sub.a, of the control signal actually used by
the actuator during the time interval, .DELTA.t;
(f) using the model, determining a computed value for the output, O.sub.c,
as a function of the value of the control signal determined in step (e);
and
(g) reiteratively repeating steps (b) through (f), each successive
iteration using values for the state variables in the model that depend on
the computed value of the output determined in step (f) of the previous
iteration, so that control of the process tracks changes in the specified
output and the process quickly converges on the specified output.
2. The method of claim 1, wherein the step of interpolating comprises the
steps of:
(a) determining the difference between the second and first control
signals, X.sub.2 -X.sub.1 ;
(b) determining the difference between the second and first corresponding
output values, O.sub.2 -O.sub.1 ;
(c) determining a slope of a line through a data pair (O.sub.1, X.sub.1)
and a data pair (O.sub.2, X.sub.2), from the relationship:
slope=(O.sub.2 -O.sub.1)/(X.sub.2 -X.sub.1); and
(d) determining the desired control signal, X.sub.d, as a function of the
specified output, O.sub.s, from the relationship:
X.sub.d =(O.sub.s -(O.sub.1 -slope*X.sub.1))/slope.
3. The method of claim 1, wherein the process includes constraints on the
values of the control signal that can be used by the actuator, and wherein
the step of operating the process for the predetermined time interval
includes the step of using a value for the control signal that
approximates the desired value of the control signal as closely as the
constraints allow.
4. The method of claim 3, wherein the constraints comprise limits on the
maximum and minimum values of the control signal.
5. The method of claim 3, wherein the constraints comprise limits on the
usable resolution for the values of the signal parameters.
6. The method of claim 3, wherein the actual control signal used may be
substantially unequal to the desired control signal X.sub.d for one or
more time intervals due to an actuator fault, said step of determining the
control signal actually used by the actuator including the step of
computing a change in the output during a total accumulated time that the
actuator fault continues, so that upon correction of the actuator fault,
the step of determining the desired value of the control signal
compensates for the total time in which the actuator was not responding to
the desired control signal.
7. The method of claim 1, wherein the model is linear with respect to
successive data pairs, each data pair comprising a control signal and a
corresponding process output.
8. The method of claim 1, wherein the time interval is of a predetermined
length unless an event is detected that alters the operation of the
process or the specified output, causing the time interval to terminate
prematurely.
9. A method for controlling the concentration of a drug administered
intravenously at a controlled rate to a recipient to achieve a specified
plasma drug concentration, wherein a linear pharmacokinetic model is used
that predicts the plasma drug concentration as a function of the rate
administered and as a function of a plurality of state variables and other
parameters that define the current concentration of the drug in the
recipient's body, said method comprising the steps of:
(a) arbitrarily selecting a first and a second rate for administering the
drug during an interval of time;
(b) using the model, determining a first and a second plasma drug
concentration corresponding respectively to the first and second rates, if
said rates were used during the interval of time;
(c) from the first and second rates and the first and second plasma drug
concentrations, determining an interpolated drug delivery rate that should
produce the specified plasma drug concentration of the drug in the
recipient at the end of the interval of time;
(d) delivering the drug to the recipient nominally at the interpolated rate
for the interval of time;
(e) determining an actual rate at which the drug is being delivered to the
recipient;
(f) using the model, determining a computed plasma drug concentration that
corresponds to the actual rate and setting the plurality of state
variables as a function of the computed plasma drug concentration; and
(g) reiteratively repeating steps (b) through (f) for successive intervals
of time, each iteration determining the interpolated rate using the model,
wherein the plurality of state variables for that iteration depend on the
computed plasma drug concentration from the previous iteration, thus
compensating for any substantial variation between the interpolated rate
of delivery and the actual rate, whereby the rate of delivery of the drug
is controlled so that the specified plasma drug concentration is rapidly
achieved.
10. The method of claim 9, wherein the drug is delivered to the recipient
by an infusion device, said infustion device being operable to deliver the
drug only at specific incremental rates, said step of delivering the drug
at the interpolated rate comprising the step of delivering the drug at one
of the specific incremental rates that is closest to the interpolated
rate.
11. The method of claim 10, wherein the step of determining the actual rate
includes the step of determining said one specific incremental rate used
to deliver the drug.
12. The method of claim 10, wherein the step of determining the actual rate
includes the step of determining if the drug was not delivered to the
recipient by detecting a fault in the infusion device.
13. The method of claim 10, wherein the step of determining the actual rate
includes the step of determining if the drug was not delivered to the
recipient by detecting an occlusion in a line through which the drug is
delivered to the recipient from the infusion device.
14. The method of claim 13, wherein the step of determining the
interpolated rate compensates for non-delivery of the drug to the
recipient for successive intervals of time, when delivery of the drug is
again resumed, because the plurality of state variables changes as the
computed plasma drug concentration changes during the time that the drug
is not delivered to the recipient.
15. The method of claim 9, wherein the interval of time is of a
predetermined duration, subject to a premature termination in response to
the occurrence of a specified event affecting the actual drug delivery
rate.
16. Apparatus for controlling a process to obtain a specified output,
O.sub.s, where the process is described by a model that defines an output
of the process as a function of a specified control signal and wherein the
process is affected by an actuator in response to the control signal, said
apparatus comprising:
(a) processor means for:
(i) arbitrarily selecting a first value, X.sub.1, and a second value,
X.sub.2, for the control signal that could be applied to control the
actuator for a time interval, .DELTA.t;
(ii) initializing a plurality of state variables used in the model;
(iii) as a function of the first and second values of the control signal,
which are input to the model, respectively determining first and second
output values, O.sub.1 and O.sub.2 ; and
(iv) interpolating with respect to the first and second values of the
control signal and corresponding first and second output values to
determine a desired value, X.sub.d, for the control signal that should
produce the specified output at the end of the time interval;
(b) means for determining successive time intervals and producing time
signals indicative of each of said time intervals;
(c) said processor means being connected to receive said time signals and
being further operative to operate the process using a closest available
control signal to the desired value X.sub.d ; and
(d) means for determining an actual value of the control signal implemented
during operation of the actuator during the interval of time; said
processor means being further operative to determine a computed value,
O.sub.c, for the output of the process as a function of the actual value,
X.sub.a, of the control signal, and to repetitively and reiteratively
determine the desired value, X.sub.d, for successive intervals of time,
using values for the plurality of state variables in the model that depend
on the computed value of the output determined in a preceding iteration,
so that the process rapidly converges on the specified output.
17. The apparatus of claim 16, wherein the processor means comprise a
microprocessor and a nonvolatile electronic memory in which is stored a
program directing the operation of the microprocessor.
18. The apparatus of claim 16, wherein the means for determining an actual
value of the control signal comprise means for determining that the
actuator was interrupted during one or more of the time intervals,
preventing the specified value of the output from being realized.
19. The apparatus of claim 16, wherein the process or means interpolate by:
(a) determining the difference between the second and first control
signals, X.sub.2 -X.sub.1 ;
(b) determining the difference between the second and first corresponding
output values, O.sub.2 -O.sub.1 ;
(c) determining the slope of a line through a data pair (O.sub.1, X.sub.1)
and a data pair (O.sub.2, X.sub.2), from the relationship:
slope=(O.sub.2 -O.sub.1)/(X.sub.2 -X.sub.1); and
(d) determining the desired control signal, X.sub.d, as a function of the
specified output, O.sub.s, from the relationship:
X.sub.d =(O.sub.s -(O.sub.1 -slope*X.sub.1))/slope.
20. Apparatus for controlling the intravenous administration of a drug to a
recipient at a controlled rate to achieve a specified plasma drug
concentration, wherein a linear model is used that determines the plasma
drug concentration as a function of the rate at which it is administered
and as a function of a plurality of state variables and other parameters
that define the current concentration of the drug in the recipient's body,
said apparatus comprising:
(a) processor means, for:
(i) selecting a first and a second arbitrary rate for administering the
drug during a time interval .DELTA.t;
(ii) using the model, determining a first and a second plasma drug
concentration that corresponds to the first and second arbitrary rates for
administering the drug; and
(iii) based on the first and second arbitrary rates and corresponding first
and second plasma drug concentrations, determining an interpolated drug
delivery rate that should produce the specified plasma drug concentration
of the drug in the recipient at the end of the time interval;
(b) infusion means, connected to the processor means, for delivering the
drug to the recipient nominally at the interpolated rate;
(c) timer means for determining successive intervals of time, said timer
means producing time signals that indicate the duration of each time
interval; and
(d) means for determining an actual rate at which the drug is administered
to the recipient by the infusion means; said processor means being further
operative to apply the model to determine a computed plasma drug
concentration that corresponds to the actual rate during a current time
interval, where the plurality of state variables used in the model vary as
a function of the computed plasma drug concentration from prior time
intervals, and being still further operative to determine an interpolated
drug delivery rate and a computed plasma drug concentration using the
model, for successive intervals of time, and thereby controlling the
infusion means to operate substantially at the interpolated drug delivery
rate so that the computed blood plasma concentration rapidly approaches
the specified plasma drug concentration.
21. The apparatus of claim 20, wherein the means for determining the actual
rate at which the drug is administered comprise an occlusion detector to
detect if an occlusion of a delivery line connecting the infusion means to
the recipient has prevented the drug from being delivered to the
recipient.
22. The apparatus of claim 20, wherein the means for determining the actual
rate at which the drug is administered comprise a fault detector that can
detect a failure in the infusion means, which prevents the drug from being
delivered to the recipient. |
|
|
|
|
Claims  |
|
|
Description  |
|
|
TECHNICAL FIELD
This invention generally pertains to a model-driven method and apparatus
for controlling an open-loop process, and specifically, to controlling the
rate at which a drug is administered to a recipient to achieve a specified
plasma drug concentration.
BACKGROUND OF THE INVENTION
Most process control schemes are closed-loop, depending upon a feedback
signal that either directly or indirectly indicates the effect on the
process output of changes in the output of one or more actuators. In an
open-loop control process, a feedback signal is normally not available,
typically because the output of the process is difficult, expensive, or
impossible to monitor in a timely fashion. Open-loop processes are
sometimes automatically controlled by using a model to predict the process
output as a function of the output from the controlled actuator. The
accuracy with which the process is controlled then depends simply on how
accurately the model reflects the actual behavior of the process.
For example, a physician using an infusion device (actuator) to administer
a drug intravenously to a patient may program an infusion device
controller to achieve user-specified plasma drug concentrations based on a
pharmacokinetic model of the drug being infused. The infusion device
controller uses the pharmacokinetic model to dynamically determine the
drug delivery rate at which the infusion device should be operated to
achieve the specified plasma drug concentration. The infusion device
infuses drug to the recipient, and the drug becomes present within the
plasma of the recipient at some concentration. Ideally, the ability of the
infusion device controller and the infusion device to achieve the
specified plasma drug concentration would depend on the accuracy and
applicability of the pharmacokinetic model. However, most drug infusion
devices have a limited range of delivery rates, and a limited resolution
for specifying or controlling the delivery rate. If the control method
computes a delivery rate that is outside the available range of delivery
rates and/or the actual delivery rate does not equal the computed rate due
to lack of resolution of the infusion device, a significant difference
between the theoretical and actual plasma drug concentrations may develop
over time. Furthermore, if, for example, sensors within the infusion
device detect an occlusion of the catheter line connecting the infusion
device to the recipient and cause the infusion device to halt drug
delivery, the theoretical and actual plasma drug concentrations may
diverge unless the controller and pharmacokinetic simulation are advised
of the interruption in drug delivery and compensate accordingly once drug
delivery is resumed. Thus, in a model-based control method, the model
simulation must be apprised of the actual output of the actuator (input to
the process), not the desired output of the actuator.
SUMMARY OF THE INVENTION
In accordance with the present invention, a method and apparatus are
provided for controlling a process to obtain a specified output, O.sub.s,
where the process is described by a model that defines an output of the
process as a function of a specified control signal. The first step in the
method provides for arbitrarily selecting a first value, X.sub.1, and a
second value, X.sub.2, for the control signal, and initializing a
plurality of state variables in the model. First and second output values,
O.sub.1 and O.sub.2, that would be obtained at the end of a time interval,
.DELTA.t, were the control signal to be applied for this time, are then
determined as a function of the first and second values of the control
parameter using the model. Assuming that a linear relationship exists
between data pairs (O.sub.1, X.sub.1) and (O.sub.2, X.sub.2), the method
interpolates with respect to these data pairs, to determine a desired
value, X.sub.d, for the control signal that should produce the specified
output.
During the time interval, the process is operated nominally using the
desired value, X.sub.d, for the control signal. While the process is being
operated, a value, X.sub.a, of the control signal actually used in the
process is determined. Using the model, a computed value for the process
output, O.sub.c, is determined as a function of the value, X.sub.a, of the
control signal. Each of these steps is reiteratively repeated, each
successive iteration using values for state variables in the model that
depend on the computed value of the process output determined in a
previous iteration. As a result, the actual process output is tracked,
causing the process to quickly converge on the specified output.
The step of interpolating includes the steps of determining the difference
between the second and first control signals, X.sub.2 -X.sub.1, and the
difference between the second and first corresponding output values,
O.sub.2 -O.sub.1. Thereafter, the slope of a line through the data pair
(O.sub.1, X.sub.1) and the data pair (O.sub.2, X.sub.2) is determined from
the relationship:
slope=(O.sub.2 -O.sub.1)/(X.sub.2 -X.sub.1).
The desired control parameter, X.sub.d, is then determined from the
relationship:
X.sub.d =(O.sub.s -(O.sub.1 -slope*X.sub.1))/slope.
In a case where the process includes constraints on the values of the
control signal that can be used in the process, the step of operating the
process for the time interval includes the step of using a value for the
control signal that approximates the desired value of the control signal
as closely as the constraints allow. As an example, the constraints may
comprise limits on the maximum and/or minimum values of the control
signal. Alternatively, the constraints may comprise limits on the
resolution of the values of the control signal usable in the process.
If the actual control signal substantially equals zero for one or more of
the time intervals due to a process fault, the step of determining the
control signal, X.sub.a, actually implemented in the process includes the
step of computing a change in the output during a total accumulated time
that the process fault continues. As a result, upon correction of the
process fault, the step of determining the desired value of the control
parameter compensates for the total accumulated time in which the process
was not operated with the desired control signal.
More specifically, the method may relate to controlling the concentration
of a drug administered intravenously at a controlled rate to a recipient
to achieve a specified plasma drug concentration, wherein a linear
pharmacokinetic model is used that predicts the plasma drug concentration
as a function of the rate the drug is administered and as a function of a
plurality of state variables and other parameters that define the current
concentration of the drug in the recipient's body. Analogous steps in
practicing this method are included as a further aspect of the invention.
Apparatus including a plurality of means for carrying out the functions
defined as steps in the above method comprise a further aspect of the
invention.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diagram illustrating the steps implemented in model-based
control of an open-loop process to achieve a specified output;
FIG. 2 is a block diagram showing the steps of the method in the present
invention as applied to obtaining a specific plasma concentration of a
drug administered by intravenous infusion, wherein the actuator is an
infusion device having a controlled delivery rate for infusing the drug
into a recipient;
FIG. 3 is a block diagram of a microprocessor control for a drug infusion
device;
FIG. 4 is a graph illustrating the plasma concentration of a drug at a
time, t, in respect to the plasma drug concentrations corresponding to two
arbitrary delivery rates, at a time, t+.DELTA.t;
FIG. 5 is a graph illustrating an interpolation step used to compute a
desired rate of infusion to achieve the specified plasma drug
concentration;
FIG. 6 is a schematic representation of a three-compartment pharmacokinetic
model of drug assimilation in the body for use in determining the plasma
concentration of the infused drug;
FIG. 7 is a transfer function defining the three-compartment model of drug
disposition in the body; and
FIGS. 8-10 represent equations defining the concentration of the drug in
each of the three compartments of the model of FIG. 6.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Although the present invention was developed specifically for controlling
the rate of intravenous infusion of a drug to achieve a specified plasma
drug concentration, it must be emphasized that the invention has general
application to any model-based control paradigm where the relationship
between time, the output of the controlled actuator (input to the
process), and the output of the process are described by a linear dynamic
model. Details of the particular model used to calculate the output of the
process as a function of the actuator output are not important to the
present invention. However, the accuracy with which the specified process
output is obtained does depend upon the quality of the model used. To
emphasize this point, FIG. 1 includes a block diagram that schematically
defines how such an open-loop process is controlled to achieve the
specified output using a model-based control paradigm. It is presumed that
the value of the actual output of the process is either difficult or
impossible to measure in a timely fashion, or is otherwise not available
as feedback signal for use in a conventional, real-time, closed-loop
control of the process.
As shown in FIG. 1, a value for the specified output of the process is
input to a block 10. In block 10, a first and a second value for the
actuator output, which nominally determine the output of the process, are
arbitrarily selected. These first and second values must not be equal to
each other and should preferably be within a range relevant to the control
process, but are otherwise entirely arbitrary. A block 12 includes
parameters and constants of equations that model and simulate the process
to be controlled as a function of an actuator output and as a function of
time intervals, .DELTA.t. With the model state variables initialized to
their state at the end of the most recent time interval, .DELTA.t.sub.n-1,
a first arbitrarily selected value for the actuator output (input to
process) to be used during .DELTA.t.sub.n is used as an input to the model
to calculate the output value that would be obtained at the end of
.DELTA.t.sub.n. With the model similarly initialized, a second arbitrary
selected value for the actuator output (input to process) to be used
during .DELTA.t.sub.n is used as an input to the model to calculate the
output value that would be obtained at the end of .DELTA.t.sub.n.
Since the model responds linearly to changes in input, a linear
relationship exists with respect to data pairs that each include one of
the arbitrarily selected first and second values for the actuator output
and the computed value for the output of the process corresponding to that
value for the period .DELTA.t.sub.n. Because of this linear relationship,
it is possible to interpolate along a line extending through these two
data pairs to determine an interpolated actuator control signal that
should nominally be used during the next time interval to achieve or
maintain the specified process output.
The interpolated signal is provided to a block 14 for controlling an
actuator to modify the output of the process. This relationship is
indicated by the arrow connecting block 14 to a block 16. Block 16 is
labeled Process, and generally represents the plant or other mechanism in
which the process is effected. The "actual output" developed by the
process in block 16 represents a quantity that would normally be used as a
feedback signal for closed-loop control of the process, if this output
could readily be measured in a timely fashion.
If the actuator is able to respond precisely to the interpolated control
signal, the actual output from block 16 should equal the desired process
output by the end of the first sampling interval, at least within the
accuracy limits of the model. However, if the interpolated control signal
is outside of the actuator's range, or if the actuator cannot respond with
as much resolution as the control signal specifies, or if the actuator is
nonfunctional for some portion of the time interval, then the actual
process output will differ from that specified.
The present invention compensates for the failure of the actuator to use
the interpolated control signal determined in block 10 exactly by using a
signal indicative of the actual output of the actuator. This signal is
input to a block 18. In block 18, the model parameters and equations from
block 12 are used to determine a computed process output that corresponds
to the actual actuator output used in controlling the process in block 16
and the actual duration of the sampling interval. The computed output of
the process may differ from the specified output due to a failure in the
actuator, lack of resolution or precision in the ability of the actuator
to use the interpolated control signal, or because the interpolated
control signal lies outside the available range of the actuator. Since the
state variables in the model used to derive the interpolated control
signal are computed from the actual performance of the actuator, not the
desired performance of the actuator, the interpolated control signal is
inherently and always that which is optimally suited to achieve the
desired process output during the next sampling interval.
At the end of each sampling interval, determined by a timer in a block 20,
a switch 22 is closed and the computed output from block 18 is input to
block 10. At the same time, a plurality of state variables developed in
the equations that define the model as a function of the actual actuator
output used as the input to the simulation of the process in block 18 are
input to block 10 through a switch 24. This switch is also controlled by
the timer in block 20. The timer in block 20 may operate at regular
predefined intervals or may also be interrupt- or event-driven.
In block 10, at the end of each preceding sampling interval, the
arbitrarily selected first and second values for the actuator output are
respectively input to the model to calculate corresponding first and
second simulated process output values, and a new interpolated control
signal is determined based on the liner relationship between the resulting
data pairs and the specified process output value. Each successive time
that a new interpolated control signal is thus determined (for a period
.DELTA.t.sub.n), the model is first updated with the state variables from
the previous iteration (for the preceding period .DELTA.t.sub.n-1), which
are provided from block 18 and which depend upon the actual actuator
output used during the previous interval of time (.DELTA.t.sub.n-1). Using
this method, the actual output of the process approaches the specified
output and tracks interruptions or variations in the operation of the
actuator.
Turning now to FIG. 2, the specific application of the present invention to
obtaining a specified plasma concentration of a drug administered
intravenously is illustrated in a schematic block diagram, similar to that
of FIG. 1. The desired plasma drug concentration is input to a block 40.
Note that in this disclosure, the word "plasma" may be used
interchangeably with words suggesting other constituents of blood (e.g.,
whole blood, serum, free fraction), depending on the particular
implementation and application. Arbitrary infusion rates are selected and
used as separate inputs to a linear pharmacokinetic model for the drug for
calculation of two corresponding plasma drug concentrations that would be
obtained if the selected infusion rates were to be utilized during the
next time interval. Based upon the linear relationship between
corresponding data pairs comprising the first and second arbitrarily
selected infusion rates and the corresponding plasma drug concentrations,
a desired infusion rate for the drug is determined by interpolation with
respect to the desired plasma drug concentration. Details of the
interpolation process are graphically illustrated in FIGS. 4 and 5.
With the pharmacokinetic model initialized to its state at the end of the
previous infusion interval, .DELTA.t.sub.n-1, a first arbitrarily selected
infusion rate X.sub.1 is input to the model defined by parameters provided
from a block 42. Using the model, a first plasma drug concentration,
O.sub.1, that would result at the end of the impending infusion interval,
.DELTA.t.sub.n, if the drug at the first arbitrarily selected infusion
rate X.sub.1 were to be delivered by the infusion device for the internal
.DELTA.t.sub.n is determined. Similarly, a second plasma drug
concentration, O.sub.2, that would result at the end of the impending
infusion interval, .DELTA.t.sub.n, if the drug at a second arbitrarily
selected infusion rate X.sub.2 (different than X.sub.1) were to be
delivered by the infusion device for the interval .DELTA.t.sub.n, is
determined. A line 70 in FIG. 5 is drawn through the data pairs (X.sub.1,
O.sub.1) and (X.sub.2, O.sub.2). A specified plasma drug concentration,
O.sub.s, defines a point at a reference numeral 72 on line 70. A vertical
line dropped from point 72 intercepts a corresponding infusion rate at
X.sub.d. Thus, the interpolated infusion rate, X.sub.d, is the desired
ideal infusion rate that should be used during the infusion interval
.DELTA.t.sub.n as an input to a block 44 to control the infusion device
for infusing drug into the recipient. All of these calculations are made
during a time much, much smaller than .DELTA.t.sub.n so that they can be
considered to have been performed substantially instantaneously during the
time between the end of .DELTA.t.sub.n-1 and the start of .DELTA.t.sub.n,
even though .DELTA.t.sub.n-1 and .DELTA.t.sub.n are step-wise continuous
in time. The infusion of the drug into the recipient's body is represented
by the line connecting block 44 to a block 46. Block 46 is labeled
Recipient's Body, but in a larger sense indicates the pharmacological
process that determine the actual plasma drug concentration. A recipient's
body weight, sex, age, and many other factors may affect the actual plasma
drug concentration resulting from a particular drug dosage, and some of
these factors may be embodied in the model parameters provided in a block
42. The only variable controlled to achieve the specified plasma drug
concentration is the rate at which the drug is infused into the recipient
by the infusion device in block 44.
Although determined graphically in FIG. 5, the interpolated delivery rate
input to the infusion device in block 44 may also be interpolated
mathematically from the corresponding data pairs (X.sub.1, O.sub.1) and
(X.sub.2, O.sub.2) and specified plasma concentration of the drug based on
the relationship:
X.sub.d =(O.sub.s -(O.sub.1 -b*X.sub.1))/b (1)
where b=(O.sub.2 -O.sub.1)/(X.sub.2 -X.sub.1)=slope of the line through
(X.sub.1, O.sub.1) and (X.sub.2, O.sub.2).
For the purposes of this disclosure and the claims that follow, the term
"interpolation" is intended to encompass both graphical and numeric
methods of determining the interpolated control signal or ideal drug
infusion rate.
The interpolation control signal or ideal drug infusion rate may not be
achieved if the infusion device in block 44 can only be set to deliver the
drug, for example, at integer values of an infusion rate. Furthermore, the
interpolated or desired ideal infusion rate may exceed the maximum
infusion rate at which the infusion device in block 44 can deliver the
drug into the recipient's body, and of course the infusion device cannot
remove drug from the recipient (negative infusion rate). Also, an
occlusion of the catheter line connecting the infusion device to the
recipient's body, or a fault in the infusion device such as mechanical
breakdown, may interrupt drug delivery to the recipient. For these and
other reasons, the infusion device may infuse the drug at an actual
infusion rate that differs from the desired rate. The present invention
compensates for these limitations. A signal indicative of the actual
infusion rate is provided from block 44 to a block 48. In block 48, the
actual infusion rate is input to the model to compute a plasma
concentration of the drug that corresponds to the actual rate of infusion
of drug into the recipient. This " actual" infusion rate is typically not
a measured infusion rate but rather is the infusion rate nominally
reported by the infusion device, which results from the electronic and/or
mechanical properties of the infusion device in the given circumstances.
Block 42 contains the model parameters, constants, and equations that are
used to define the simulation of the process in block 48 so that the
theroretical plasma concentration can be computed. At the end of an
infusion interval .DELTA.t.sub.n, the timer in a block 50 closes a switch
56 so that a signal indicative of the actual infusion rate generated by
the infusion device during .DELTA.t.sub.n is input to block 48. At the end
of an infusion interval .DELTA.t.sub.n, determined by a timer in block 50,
a switch 52 is closed to provide the computed plasma concentration as an
input to block 40. In addition, the timer in block 50 closes a switch 54
so that state variables corresponding to parameters in the model that
change with each computation of a new computed plasma concentration are
input to block 40. Also, after each predetermined time interval, block 40
again determines the desired infusion rate by interpolation between the
data pairs comprising the arbitrarily selected first and second delivery
rates and corresponding plasma concentrations that are determined each
time from the model. As this iterative process proceeds, the actual plasma
concentration in the recipient's body quickly approaches the specified
plasma concentration input to block 40 (unless infusion of the drug is
interrupted by an infusion device fault or an occlusion of a catheter
line, for example).
Switches 52, 54, and 56 conveniently represent gated data transfer events
and are not actual electrical switches. Typically, these switches will be
gated at the end of each particular sampling interval .DELTA.t.sub.n, but
the timer in block 50 that gates these switches may be event- or
interrupt-driven such that data transfer occurs at a time before the
scheduled end of .DELTA.t.sub.n. Examples of events that would ideally
result in the premature termination of the current infusion period are
when the microprocessor detects an error or fault condition altering the
rate of drug delivery or when a new specified plasma drug concentration is
entered by the user into block 40. In any case, the timer in block 50
determines the actual duration of each sampling interval and reports that
interval to the simulation in block 48.
If a physician changes the value of the specified plasma concentration of
the drug that is input to block 40, the ideal or desired infusion rate
changes correspondingly. The state variables that are transferred through
switch 54 from block 48 to block 40 and the computed value for plasma
concentration that are used in each successive iteration compensate for
the change in delivery rate to achieve the new specified plasma
concentrations. As shown in FIG. 5, the value for the computed plasma
concentration, O.sub.c, at time t, forms a basis for computing the plasma
concentration corresponding to the arbitrarily selected rates of infusion
X.sub.1 and X.sub.2, at time t+.DELTA.t. In the preferred embodiment, the
timer in block 20 normally closes switches 52, 54, and 56 at nine-second
intervals, i.e., .DELTA.t=9 seconds, unless interrupted prior to the end
of that time. Due to the relatively short time interval between
iterations, the control method readily tracks changes in the desired
plasma concentration input by medical personnel.
Referring to FIG. 3, a control that implements the above-described method
comprising one aspect of the present invention is illustrated in a block
diagram. The control includes a microprocessor 100, which is connected to
a random access memory (RAM) 102 in which data is temporarily stored, and
to a read-only memory (ROM) 104 in which are defined program steps
implemented by the microprocessor for controlling the infusion device to
deliver a drug to a patient. A time base 106 is connected to
microprocessor 100, and may comprise a crystal controlled oscillator or
conventional RC circuit, as is well known to those of ordinary skill in
the art. Using time base 106 as a time/frequency reference, microprocessor
100 determines the predetermined interval of time for each successive
iteration in blocks 40 and 48. Also connected to microprocessor 100 are a
display 108 and a keypad 110. In response to prompt messages made to
appear on display 108, medical personnel enter data describing
characteristics of the patient that are required by the model, the type of
drug to be infused, and the desired plasma concentration of the drug. The
prompt messages shown on display 108 comprise part of the program steps
stored in ROM 104, and the data entered by the medical personnel are
temporarily stored in RAM 102.
Microprocessor 100 controls an infusion device 112 to infuse the drug as
described above. Although control of infusion device 112 involves many
other considerations, for purposes of this disclosure, the primary control
parameter effected in infusion device 112 by the microprocessor is the
rate at which the infusion device delivers drug to the patient. Since the
control including microprocessor 100 is integral with infusion device 112
in the preferred embodiment, the rate of infusion and resolution with
which this parameter is achievable by the infusion device are stored in
ROM 104 and are thus readily accessible by microprocessor 100. For
example, infusion device 112 may have an operating range of infusion rates
of between 10 and 999 ml per hour, specifiable only in integer values.
Microprocessor 100 determines the actual infusion rate (at least in part)
from such data.
A drug reservoir 116 is connected to supply the drug at the specific
concentration to infusion device 112 through a supply line 118. The drug
is typically infused intravenously into a recipient 122 through a catheter
line 120. Infusion device 112 includes a plurality of sensors for
detecting fault conditions that can prevent the infusion device from
delivering the drug to a patient. For example, the sensors can detect an
occlusion in catheter line 120, and other fault conditions. In response to
any such fault condition, sensors 114 produce a binary signal indicating
that the drug is not being delivered to recipient 122. As noted above, the
actual infusion rate is determined by microprocessor 100, with respect to
the operating specifications for infusion device 112 that are stored
within ROM 104, and also with respect to one or more binary signals
supplied to the microprocessor from sensors 114. Microprocessor 100 thus
compensates for changes in the plasma drug concentration caused by any
interruption of drug infusion, by using an actual infusion rate equal to
zero during the simulation of the process in block 48 of FIG. 2 while the
interruption continues. Once the fault is corrected and delivery of the
drug to the recipient is resumed, a non-zero value for the actual delivery
rate, which reflects the actual operating capabilities of the infusion
device is again input to block 48 to determine the current value of
computed plasma concentration of the drug, compensated for the period of
time in which drug was not infused into the recipient.
To better appreciate the advantages of the present invention in controlling
the open-loop drug infusion process represented in FIG. 2, it is helpful
to understand a specific model used for calculating the plasma
concentration of a drug as a function of the rate at which the drug is
infused | | |