Extended model of impaired cerebral autoregulation in preterm infants: Heuristic feedback control

Nikolai D. Botkin, Varvara L. Turova, Andrey E. Kovtanyuk, Irina N. Sidorenko, Renée Lampe

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Cerebral autoregulation is the ability to keep almost constant cerebral blood flow (CBF) for some range of changing the mean arterial pressure (MAP). In preterm infants, this range is usually very small, even absent, and a passive (linear) dependence of CBF on MAP is observed. Also, variations of the partial CO2 pressure and intracranial/venous pressure result in fluctuations of CBF. The absence of cerebral autoregulation may be a cause of intracranial hemorrhages due to instability of cerebral blood vessels, especially in the so-called germinal matrix which exists in a developing brain from 22 to 32 weeks of gestation. In the current paper, a mathematical model of impaired cerebral autoregulation is extended compared with previous works of the authors, and a heuristic feedback control that is able to keep deviations from a nominal CBF within a reasonable range is proposed. Viability theory is used to prove that this control can successfully work against a wide range of disturbances.

Original languageEnglish
Pages (from-to)2334-2352
Number of pages19
JournalMathematical Biosciences and Engineering
Volume16
Issue number4
DOIs
StatePublished - 2019

Keywords

  • Cerebral autoregulation
  • Discriminating kernel
  • Feedback control
  • Grid method
  • Leadership kernel
  • Viability set

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