Philippe Micheau

A prototype of volume-controlled tidal liquid ventilator using independent piston pumps.

Liquid ventilation using perfluorochemicals (PFC) offers clear theoretical advantages over gas ventilation, such as decreased lung damage, recruitment of collapsed lung regions, and lavage of inflammatory debris. We present a total liquid ventilator designed to ventilate patients with completely filled lungs with a tidal volume of PFC liquid. The two independent piston pumps are volume controlled and pressure limited. Measurable pumping errors are corrected by a programmed supervisor module, which modifies the inserted or withdrawn volume. Pump independence also allows easy functional residual capacity modifications during ventilation. The bubble gas exchanger is divided into two sections such that the PFC exiting the lungs is not in contact with the PFC entering the lungs. The heating system is incorporated into the metallic base of the gas exchanger, and a heat-sink–type condenser is placed on top of the exchanger to retrieve PFC vapors. The prototype was tested on 5 healthy term newborn lambs (<5 days old). The results demonstrate the efficiency and safety of the prototype in maintaining adequate gas exchange, normal acido-basis equilibrium, and cardiovascular stability during a short, 2-hour total liquid ventilator. Airway pressure, lung volume, and ventilation scheme were maintained in the targeted range.

Methodology for optimal configuration in structural health monitoring of composite bonded joints

In this study, a structural health monitoring (SHM) strategy is proposed in order to detect disbonds in a composite lap-joint. The structure under study is composed of a carbon fiber reinforced polymer (CFRP) bonded to a titanium plate and artificial disbonds are simulated by inserting Teflon tapes of various dimensions within the joint. In situ inspection is ensured by piezoceramics bonded to the structure to generate and measure guided waves. Theoretical propagation and through-thickness stress distribution are first studied in order to determine damage sensitivity with respect to the mode and frequency of the generated guided wave. The optimal configuration of the system in terms of piezoceramic size, shape and inter-unit spacing is then validated using finite element modeling (FEM) in 3D. Experimental assessment of propagation characteristics is conducted using laser Doppler vibrometer (LDV) in order to justify theoretical and numerical assumptions and pitch–catch measurements are then performed to validate the efficient detection of the damage and accurate estimation of its size.

A Regulator for Pressure-Controlled Total-Liquid Ventilation

Total-liquid ventilation (TLV) is an innovative experimental method of mechanical-assisted ventilation in which lungs are totally filled and then ventilated with a tidal volume of perfluorochemical liquid by using a dedicated liquid ventilator. Such a novel medical device must resemble other conventional ventilators: it must be able to conduct controlled-pressure ventilation. The objective was to design a robust controller to perform pressure-regulated expiratory flow and to implement it on our latest liquid-ventilator prototype (Inolivent-4). Numerical simulations, in vitro experiments, and in vivo experiments in five healthy term newborn lambs have demonstrated that it was efficient to generate expiratory flows while avoiding collapses. Moreover, the in vivo results have demonstrated that our liquid ventilator can maintain adequate gas exchange, normal acid-base equilibrium, and achieve greater minute ventilation, better oxygenation and CO2 extraction, while nearing flow limits. Hence, it is our suggestion to perform pressure-controlled ventilation during expiration with minute ventilation equal or superior to 140&nbsp;mL· min-1·kg-1 in order to ensure PaCO2 below 55 mmHg. From a clinicians point of view, pressure-controlled ventilation greatly simplifies the use of the liquid ventilator, which will certainly facilitate its introduction in intensive care units for clinical applications.

Structural health monitoring strategy for detection of interlaminar delamination in composite plates

In this paper, a structural health monitoring strategy for detecting interlaminar delamination in a carbon fiber reinforced polymer structure using Lamb waves is proposed. The delamination is simulated by inserting a Teflon tape between two transverse plies and the Lamb wave generation and measurement is enabled by using piezoceramic elements. The Lamb wave theoretical propagation and through thickness strain distribution are studied, in order to determine the optimal configuration of the final system in terms of mode and frequency selection, and piezoceramic sizing and spacing, for detection of cross-sectional delamination. Pitch and catch measurements are performed by comparing wave propagations for different frequencies and along damaged and undamaged paths of the structure, and the analysis of results is performed using the reassigned short time Fourier transform. It appears that in the low frequency range (below 300 kHz), the A0 mode is sensitive to the damage, while in the high frequency range, S1 and A1 modes are both very sensitive to the damage while the propagation of the S0 mode is not affected very much.

Evaluation of the lambda model for human postural control during ankle strategy

Abstract.An accurate modeling of human stance might be helpful in assessing postural deficit. The objective of this article is to validate a mathematical postural control model for quiet standing posture. The postural dynamics is modeled in the sagittal plane as an inverted pendulum with torque applied at the ankle joint. The torque control system is represented by the physiological lambda model. Two neurophysiological command variables of the central nervous system, designated λ and μ, establish the dynamic threshold muscle at which motoneuron recruitment begins. Kinematic data and electromyographic signals were collected on four young males in order to measure small voluntary sway and quiet standing posture. Validation of the mathematical model was achieved through comparison of the experimental and simulated results. The mathematical model allows computation of the unmeasurable neurophysiological commands λ and μ that control the equilibrium position and stability. Furthermore, with the model it is possible to conclude that low-amplitude body sway during quiet stance is commanded by the central nervous system.

Hypothermic Total Liquid Ventilation Is Highly Protective Through Cerebral Hemodynamic Preservation and Sepsis-Like Mitigation After Asphyxial Cardiac Arrest.

Objectives:Total liquid ventilation provides ultrafast and potently neuro- and cardioprotective cooling after shockable cardiac arrest and myocardial infarction in animals. Our goal was to decipher the effect of hypothermic total liquid ventilation on the systemic and cerebral response to asphyxial cardiac arrest using an original pressure- and volume-controlled ventilation strategy in rabbits. Design:Randomized animal study. Setting:Academic research laboratory. Subjects:New Zealand Rabbits. Interventions:Thirty-six rabbits were submitted to 13 minutes of asphyxia, leading to cardiac arrest. After resumption of spontaneous circulation, they underwent either normothermic life support (control group, n = 12) or hypothermia induced by either 30 minutes of total liquid ventilation (total liquid ventilation group, n = 12) or IV cold saline (conventional cooling group, n = 12). Measurements and Main Results:Ultrafast cooling with total liquid ventilation (32°C within 5 min in the esophagus) dramatically attenuated the post–cardiac arrest syndrome regarding survival, neurologic dysfunction, and histologic lesions (brain, heart, kidneys, liver, and lungs). Final survival rate achieved 58% versus 0% and 8% in total liquid ventilation, control, and conventional cooling groups (p < 0.05), respectively. This was accompanied by an early preservation of the blood-brain barrier integrity and cerebral hemodynamics as well as reduction in the immediate reactive oxygen species production in the brain, heart, and kidneys after cardiac arrest. Later on, total liquid ventilation also mitigated the systemic inflammatory response through alteration of monocyte chemoattractant protein-1, interleukin-1&bgr;, and interleukin-8 transcripts levels compared with control. In the conventional cooling group, cooling was achieved more slowly (32°C within 90–120 min in the esophagus), providing none of the above-mentioned systemic or organ protection. Conclusions:Ultrafast cooling by total liquid ventilation limits the post–cardiac arrest syndrome after asphyxial cardiac arrest in rabbits. This protection involves an early limitation in reactive oxidative species production, blood-brain barrier disruption, and delayed preservation against the systemic inflammatory response.

Measurement of Fractional Order Model Parameters of Respiratory Mechanical Impedance in Total Liquid Ventilation

This study presents a methodology for applying the forced-oscillation technique in total liquid ventilation. It mainly consists of applying sinusoidal volumetric excitation to the respiratory system, and determining the transfer function between the delivered flow rate and resulting airway pressure. The investigated frequency range was f ∈ [0.05, 4] Hz at a constant flow amplitude of 7.5 mL/s. The five parameters of a fractional order lung model, the existing “5-parameter constant-phase model,” were identified based on measured impedance spectra. The identification method was validated in silico on computer-generated datasets and the overall process was validated in vitro on a simplified single-compartment mechanical lung model. In vivo data on ten newborn lambs suggested the appropriateness of a fractional-order compliance term to the mechanical impedance to describe the low-frequency behavior of the lung, but did not demonstrate the relevance of a fractional-order inertance term. Typical respiratory system frequency response is presented together with statistical data of the measured in vivo impedance model parameters. This information will be useful for both the design of a robust pressure controller for total liquid ventilators and the monitoring of the patients respiratory parameters during total liquid ventilation treatment.

Effects of postnatal smoke exposure on laryngeal chemoreflexes in newborn lambs.

Laryngeal chemoreflexes (LCR), which are elicited by the contact of liquids such as gastric refluxate with laryngeal mucosa, may trigger some cases of sudden infant death syndrome. Indeed, while LCR in mature mammals consist of protective responses, previous animal data have shown that LCR in immature newborns can include laryngospasm, apnea, bradycardia, and desaturation. The present study was aimed at testing the hypothesis that postnatal exposure to cigarette smoke is responsible for enhancing cardiorespiratory inhibition observed with LCR. Eight lambs were exposed to cigarette smoke (20 cigarettes/day) over 16 days and compared with seven control lambs. Urinary cotinine/creatinine ratio was measured at a level relevant to previously published levels in infants. On days 15 and 16, 0.5 ml of HCl (pH 2), milk, distilled water, or saline was injected onto the larynx via a chronic supraglottal catheter during sleep. Results showed that exposure to cigarette smoke enhanced respiratory inhibition (P < 0.05) and tended to enhance cardiac inhibition and decrease swallowing and arousal during LCR (P < 0.1). Overall, these results were observed independently of the state of alertness and the experimental solution tested. In conclusion, 16-day postnatal exposure to cigarette smoke increases cardiorespiratory inhibition and decreases protective mechanisms during LCR in nonsedated full-term lambs.

Decentralized harmonic active vibration control of a flexible plate using piezoelectric actuator-sensor pairs.

We have investigated decentralized active control of periodic panel vibration using multiple pairs combining PZT actuators and PVDF sensors distributed on the panel. By contrast with centralized MIMO controllers used to actively control the vibrations or the sound radiation of extended structures, decentralized control using independent local control loops only requires identification of the diagonal terms in the plant matrix. However, it is difficult to a priori predict the global stability of such decentralized control. In this study, the general situation of noncollocated actuator-sensor pairs was considered. Frequency domain gradient and Newton-Raphson adaptation of decentralized control were analyzed, both in terms of performance and stability conditions. The stability conditions are especially derived in terms of the adaptation coefficient and a control effort weighting coefficient. Simulations and experimental results are presented in the case of a simply supported panel with four PZT-PVDF pairs distributed on it. Decentralized vibration control is shown to be highly dependent on the frequency, but can be as effective as a fully centralized control even when the plant matrix is not diagonal-dominant or is not strictly positive real (not dissipative).

Decentralized harmonic control of sound radiation and transmission by a plate using a virtual impedance approach

The problem under study in this article is the active control of sound transmission and radiation of a panel under a periodic excitation. The control strategy investigated uses independent control loops between an individual polyvinylidene fluoride (PVDF) sensor and an individual lead zirconate titanate (PZT) actuator. The specific approach employed here uses the concept of virtual impedance. The aim is to determine for each frequency the optimal impedance between each PVDF sensor and the corresponding PZT actuator in order to reduce the sound power radiated by the plate. Theoretical predictions are compared to measurements of the sound radiated and transmission loss of a panel mounted with eight PZT-PVDF units. Reductions of up to 20 dB of the acoustic power can be achieved around mechanical resonances of the system, while the control strategy has little effect for off-resonance excitations.