Improving breathing effort estimation in mechanical ventilation via optimal experiment design

Abstract

Estimation of the breathing effort and relevant lung parameters of a ventilated patient is essential to keep track of a patient's clinical condition. The aim of this paper is to increase estimation accuracy through experiment design. The main method is an experiment design approach across multiple breaths within a linear regression framework to accurately identify the patient's condition. Identifiability and persistence of excitation are used to formulate an estimation problem with a unique solution. Furthermore, Fisher information is used for assessing the parameters sensitivity to slight changes of the ventilator settings to improve the variance of the estimation. The estimation method is applied to simulated patients who breathe regularly but also to patients who have variable breathing patterns. A virtual experiment is conducted for both situations to generate estimation results. The results are analyzed using mathematical tools and show that uniquely estimating the lung parameters and breathing effort over multiple breaths for both regularly and variably breathing patients is possible in the presented framework. The proposed estimation method obtains clinically relevant estimates for a large set of breathing disturbances from the simulation case-study.