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Abstract The purpose of the thesis is to develop an automatic control model for the cardiac output monitor and diagnostic unit (COMDU) of the Phoenix-7 total artificial heart. By utilizing the model, operators need only to setup the required heart rate, systolic ratio, cardiac output, while the COMDU will adjust the inlet-air pressure for both the left and right heart spontaneously according to the physical requirements. We establish fuzzy rules for the input parameters of heart rate, systolic ratio, required cardiac output, and the output parameters of inlet-air pressure, inlet timing, exhausting timing with the various conditions of aortic pressures and pulmonary artery pressure. The main work of the research concentrates on developing the control models for increasing cardiac output, decreasing cardiac output, modifying the differential air exhausting period for left / right hearts. To accord with the control model, hardware of the COMDU would be promoted with the function of automatic control for left / right side pressures, air filling period and air exhausting period in the future. Keywords cardiac output monitor and diagnostic unit, fuzzy control. 2
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iv v vi vii ix 1 1.1 1 1.2 4 1.3 5 1.4 5 6 2.1 6 2.2 7 2.3 8 14 3.1 14 3.1.1 14 3.1.2 19 3.1.3 23 3.2 27 34 4.1 34 4.2 LP RP 35 4.3 LAP RAP 43 4.4 HR 50 59 60 4
1.1 / 3 1.2 3 2.1 8 2.2 8 2.3 x = 0.27 9 2.4 11 3.1 15 3.2 16 3.3 3.4 LAP=120 mmhg LP 140 170 mmhg CO 16 RAP=20 mmhg RP 30 60 mmhg CO 17 3.5 / 17 3.6 19 3.7 19 3.8 3.9 21 21 3.10 SV 22 3.11 LP=157 mmhg RP=46 mmhg CO 23 3.12 HR 24 3.13 24 3.14 25 3.15 LP RP 25 3.16 [18] 27 3.17 FLC2 28 3.18 CO LP=150 mmhg RP=40 mmhg 28 3.19 SR SR 40% 29 3.20 dt 29 3.21 SV SV SV 83.3 30 5
3.22 CO 31 3.23 SR 31 3.24 SR dt 32 3.25 SV 32 4.1 LAP=110 mmhg CO LP 35 4.2 LAP=110 mmhg LP 36 4.3 LAP=120 mmhg CO LP 36 4.4 LAP=120 mmhg LP 37 4.5 LAP=130 mmhg CO LP 37 4.6 LAP=130 mmhg LP 38 4.7 RAP=10 mmhg CO RP 39 4.8 RAP=10 mmhg RP 39 4.9 RAP=20 mmhg CO RP 40 4.10 RAP=20 mmhg RP 40 4.11 RAP=30 mmhg CO RP 41 4.12 RAP=30 mmhg RP 41 4.13 LP=140 mmhg CO L LAP=110 120 130 mmhg 43 4.14 LAP LP 44 4.15 LP=150 mmhg CO L LAP=110 120 130 mmhg 44 4.16 LAP LP 45 4.17 LP=170 mmhg CO L LAP=110 120 130 mmhg 45 4.18 LP 46 4.19 RP=40 mmhg CO R 47 4.20 RP 47 4.21 RP=50 mmhg CO R 48 4.22 RP 48 4.23 HR=40 beat/min 51 4.24 51 4.25 52 6
4.26 SV 52 4.27 HR=60 beat/min 53 4.28 LP RP 53 4.29 SV 54 4.30 HR=80 beat/min 54 4.31 55 4.32 55 4.33 SV 56 4.34 HR=100 beat/min 56 4.35 57 4.36 57 4.37 SV 58 7
1.1 Systemic circulation Pulmonary circulation 1. 2. Cardiac Output CO 5 ~ 6liter min 15 ~ 22liter min 2.5liter min Stroke Volume SV Heart Rate HR CO = HR SV 1 HR beat min SV liter beat 8
Dr. Kolff [8] 1992 35,000 2000 Dacron Graft Quick Connector AO Aorta PA Pulmonary Artery RA Right Atrium LA Left Atrium Polyurethane PU Systole 1.1[19] Diastole PU PU 9
1.1 / 1.2[19] Frank-Starling Law of the Heart 1.2 1 2 Thrombosis Embolisom Hemolysis 3 4 10
1.2 Dr. Kolff [8] 1992 35,000 2000 1969 Dr. Cooley Liotta Heart 64 Barnes [1] 1973 dp dt Levinson et al. [9] 1986 dp dt 4500 mm-hg/s DeVries [10] 1988 dp dt 112 620 Setsuo Takatani [12] Copeland [3] 1989 Jarvik-7 dp dt max 3500 mm-hg/s Kyong-Sik Om [13] 1999 Hsu et al. [5] 2000 / Hsu [6] 2001 trial and error 11
1.3 HR SR CO / 1.4 [18] LP RP LAP RAP SR HR 12
2.1 incomplete ambiguity imprecision randomness fuzziness X A 0,1 membership function µ A A ( x) µ X [0,1] ( ) {( x ( x) ) x X } [ ] A =, µ A 2.1 x X µ x x A x1, x2, x3 K x n A 2.2 ( x ) x1 + µ A ( x2 ) x2 + A ( xn ) xn A = µ A 1 L+ µ 2.2 n ( x ) x = µ ( x ) x = µ A i i x X i= i 1 A i i 2.2 + LP LP = {140,145,150, L, 160, 165,170} {( 140 ) + ( 145) + ( 150) + + ( 160) + ( 165) + ( 170) } LP = L 2.3 LP NB NS ZE PS PB 13
NB = 1 + 0.8 + L+ 0.2 + 140 141 144 0 145 NS = 0 + 0.2 + L+ 1 + L+ 0.2 140 142 145 149 + ZE = 0 + 0.2 + L+ 1 + L+ 0.1 145 146 150 159 + PS = 0 + 0.1 + L+ 1 + L+ 0.1 150 151 160 169 + PB = 0 + 0.2 + L0.8 160 161 169 + 1 170 0 150 0 160 0 170 ( x) = µ ( x) ( x) µ max A B A µ B ( x) = µ ( x) ( x) µ min A B A µ B ( x) = 1 ( x) µ A µ A 2.2 PID FLC Fuzzy Logic Controller FLC 14
2.1 2.3 2.2 2.2 15
fuzzification singleton fuzzy number 1 2 [ 1, + 1] 3 2.3 x = 0.27 16
2.3 0~0.5 ( ) µ 0.27 µ 0.27 1 2 ( ) DML FLC Fuzzy implication composition operators Union R = ( Ai Bi ) i n n U R i i = C = 1 U i = 1 2.5 ' ' ' A B C C ' ' ' ( A B ) o R = 2.6 = = C ' n ' ' U( A B ) o ( Ai Bi Ci ) i= 1 n U i= 1 ' ' [ A o ( A C )] B o ( B C ) i ( w) µ ( u) * µ ( w) U n i= 1 i [ ] [ ] [ µ () v * ( w) ] A i C i i B i i µ = µ 2.7 A ' B ' fuzzy-singleton u = u 0 v = v 0 0 µ C ' [ ] [ µ ( v ) ( w) ] ( w) µ ( u )* µ ( w) U n i= 1 = µ U n i= 1 A i 0 C B 0 * i [( ( u ) µ ( v )) ( w) ] A i 0 B 0 * i i C i C i C = µ µ 2.8 i MIN IF THEN i R i 17
fuzzy relation R i ( Ai Bi ) Ci = min 2.9 min 2.4 2.4 KB Data Base Rule Base IF THEN CO = { NB, NS, ZE, PS, PB} LP { NB, NS, ZE, PS, PB} { NB, NS, ZE, PS PB} CO =, = and control output R1 if R2 if R3 if R4 if R5 if CO is NB and LP is NB then control is NB CO is NB and LP is NS then control is NB CO is NB and LP is ZE then control is NB CO is NB and LP is PS then control is NS CO is NB and LP is PB then control is ZE 18
R21 if CO is PB and LP is NB then control is ZE R22 if R23 if R24 if R25 if CO is PB and LP is NS then control is PS CO is PB and LP is ZE then control is PB CO is PB and LP is PS then control is PB CO is PB and LP is PB then control is PB control rules base FLC completeness consistency interactivity DFI MC MOM COA WAM i. ii. MOM MC 2.10 k C crsip k = i = 1 k C i 2.10 19
iii. COM ( ) 2.11 µ c j c j c n j= µ 1 crisp = n j= 1 j ( c j ) c ( c ) µ j j j j 2.11 iv. singleton 2.12 y w i i y iwi U = 2.12 y i 20
3.1 3.1.1 CO HR SR LP RP LAP RAP CO = HR * SV SV Stroke Volume CO [18] LAP 110 120 130mmHg RAP 10 20 30mmHg CO CO HR Heart Rate 30~120 SR Stroke Volume 30% ~ 80% LP RP / 140~170 mmhg 30~60 mmhg LAP RAP / 110~130 mmhg 10~30 mmhg CO 3~10 liter/min HR=60 beat/min SR=40% CO=5 liter/min LAP=120mmHg SV ( SV = p) * SR * α 21
p LP LAP α CO CO { } set g 2,2 LP LP 150 mmhg 3.1 β SR SV ( SV = p) * SR * β p RP RAP β liter/mmhg 3.1 { 2,2} FLC CO 5,2 g { } CO CO 10 liter/min 3 liter/min CO 5 liter/min 22
3.2 3.3 3.5 10 mmhg LP=170 mmhg LP=140 mmhg 3.3 LAP=120 mmhg LP 140 170 mmhg CO 23
RP=60 mmhg 10 mmhg RP=30 mmhg 3.4 RAP=20 mmhg RP 30 60 mmhg CO 3.5 / 24
3.5 100 [14] 70~90 100 100 SR 80% 80% 40%~50% SR 100 SR=50% CO SR 25
3.1.2 3.6 SR SV SR 50% CO 3.6 FLC2 3.7 26
=75 LP 5 fuzzy sets LAP 5 fuzzy sets SR 3 fuzzy sets Rule1. if LAP=NB and LP=NB and SR=NB then CO=NB Rule2. if LAP=NS and LP=NB and SR=NB then CO=NB Rule21.if LAP=NB and LP=PB and SR=ZE then CO=ZE Rule22.if LAP=NS and LP=PB and SR=ZE then CO=PS Rule74.if LAP=PS and LP=PB and SR=PB then CO=PB Rule75.if LAP=PB and LP=PB and SR=PB then CO=PB LAP SR CO FLC 110 120 130mmHg 1 27
10 mmhg LP=170 mmhg LP=140 mmhg 3.8 10 mmhg RP=60 mmhg RP=30 mmhg 3.9 28
3.10 SV { } SR 0.3,0.8 0.5 3.8 3.9 LP=170 mmhg RP=60 mmhg HR 3 liter/min 10 liter/min 10~30 mmhg 30 mmhg 3.10 29
3.1.3 HR 55~70 beat/min LP=140~170 mmhg RP=30~60 mmhg HR 30~120 beat/min CO LP RP SV CO HR CO 5 liter/min HR CO LP RP HR=60 beat/min SR=40% CO=5 liter/min CO L CO R 3.11 LP=157 mmhg RP=46 mmhg CO 30
HR 76 beat/min 3.12 CO L CO R 3.12 HR LP RP 3.13 31
HR=76 beat/min CO L CO R 3.14 3.15 LP RP 32
LP RP CO 3.12 60 3.13 LP RP 3.14 CO 5.5 liter/min 3.15 LP 140.8 mmhg RP 30.8 mmhg 33
3.2 [18] 3.16 dt dt = t L t R [18] LP=157 mmhg RP=46 mmhg 76 beat/min 52% LAP RAP LP RP LP=157mmHg RP=46mmHg LAP=120mmHg RAP=20mmHg 3.16 [18] 34
60 (1 SR) HR SR FLC2 3.17 FLC2 HR=60 beat/min 3.18 3.21 HR=60 beat/min CO=5 liter/min [18] 3.18 CO LP=150 mmhg RP=40 mmhg 35
3.19 SR SR 40% 3.20 dt 36
3.21 SV SV SV 83.3 3.20 [18] 2~3 mmhg -2 2 3.22~ 3.25 HR=76 beat/min SV 70~100 HR CO 5 liter/min 37
CO L CO R 3.22 CO 3.23 SR 38
3.24 SR dt 3.25 SV 39
3.22~ 3.25 CO 5.9 liter/min SR=35.6% SV 77.6 40
4.1 5~6 liter/min 10 liter/min 5 liter/min COL Left air pressure LP 140~170 mmhg ( ) Aortic pressure LAP 110~130 mmhg LAP 120 mmhg LP 150 mmhg CO 5 liter/min MATLAB Fuzzy Logic Toolbox COR Right air pressure RP 30~60 mmhg Pulmonary aortic pressure RAP 10~30 mmhg CO 5 liter/min RP=40 mmhg RAP=20 mmhg LP RP 41
4.2 LP RP LAP SR LAP RAP LP CO LP CO LP RP 4.1~ 4.6 CO HR=60 beat/min SR=40 % CO=5 liter/min LP 140 170 mmhg 5 mmhg LP=170 mmhg LP=140 mmhg 4.1 LAP=110 mmhg CO LP 42
4.2 LAP=110 mmhg LP LP 140 170 mmhg 5 mmhg LP=170 mmhg LP=140 mmhg 4.3 LAP=120 mmhg CO LP 43
4.4 LAP=120 mmhg LP LP 140 170 mmhg 5 mmhg LP=170 mmhg LP=140 mmhg 4.5 LAP=130 mmhg CO LP 44
4.6 LAP=130 mmhg LP LP=150 mmhg LAP=120 mmhg 5 liter/min 4.1 LP=165 mmhg 170 mmhg 100 SR 50% CO 4.1 4.5 LP 140 mmhg SV 70 4.7~ 4.12 HR=60 beat/min SR=40 % CO=5 liter/min 45
RP 30 60 mmhg 5 mmhg RP=60 mmhg RP=30 mmhg 4.7 RAP=10 mmhg CO RP 4.8 RAP=10 mmhg RP 46
RP 30 60 mmhg 5 mmhg RP=60 mmhg RP=30 mmhg 4.9 RAP=20 mmhg CO RP 4.10 RAP=20 mmhg RP 47
RP 30 60 mmhg 5 mmhg RP=60 mmhg RP=30 mmhg 4.11 RAP=30 mmhg CO RP 4.12 RAP=30 mmhg RP 48
4.8 4.10 4.12 RAP RP 4.7 4.1 4.10 RP=40 mmhg RAP=20 mmhg CO 5 liter/min 49
4.3 LAP RAP LAP LAP RAP HR=60 beat/min SR=40 % CO=5 liter/min LAP 110 130 mmhg 10 mmhg LAP=110 mmhg LAP=130 mmhg 4.13 LP=140 mmhg CO L LAP=110 120 130 mmhg 50
LAP=130 mmhg LAP=110 mmhg 4.14 LAP LP LAP 110 130 mmhg 10 mmhg LAP=110 mmhg LAP=130 mmhg 4.15 LP=150 mmhg CO L LAP=110 120 130 mmhg 51
LAP=130 mmhg LAP=110 mmhg 4.16 LAP LP LAP=110 mmhg LAP 110 130 mmhg 10 mmhg LAP=130 mmhg 4.17 LP=170 mmhg CO L LAP=110 120 130 mmhg 52
LAP=130 mmhg LAP=110 mmhg 4.18 LP 4.13 4.18 LAP CO 53
COR RAP 10 30 mmhg 10 mmhg RAP=10 mmhg RAP=30 mmhg 4.19 RP=40 mmhg CO R RAP=30 mmhg RAP=10 mmhg 4.20 RP 54
RAP 10 30 mmhg 10 mmhg RAP=10 mmhg RAP=30 mmhg 4.21 RP=50 mmhg CO R RAP=30 mmhg RAP=10 mmhg 4.22 RP 55
4.13~4.22 LP RP LAP RAP CO LP RP CO 56
4.4 HR HR 60 beat/min HR LP RP LAP RAP SV 70 ~100 HR CO LP RP 100 CO = HR SV HR 120 beat/min CO 12 liter/min CO 3~10 liter/min 12 liter/min CO CO HR LP=150 mmhg RP=40 mmhg LAP=120 mmhg RAP=20 mmhg SR=40% HR=40 beat/min HR=60 beat/min HR=80 beat/min HR=100 beat/min 4.23~4.26 4.27~4.29 4.30~4.33 4.34~4.37 57
4.23 HR=40 beat/min 4.24 58
4.25 4.26 SV 59
COL COR 4.27 HR=60 beat/min LP RP 4.28 LP RP 60
4.29 SV 4.30 HR=80 beat/min 61
4.31 4.32 62
4.33 SV 4.34 HR=100 beat/min 63
4.35 4.36 64
4.37 SV 4.23 4.37 CO HR LP RP SV HR HR 40 beat/min LP HR 80 beat/min 100 beat/min 1. COs beat/min COs liter/min 40 3.8 MAX 50 4.8 MAX 60 5 70 5.2 MIN 80 5.8 MIN 90 6.5 MIN 100 7.2 MIN 1. COs 65
[18] ( ) 66
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