{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T17:29:28Z","timestamp":1788024568303,"version":"build-2784847793"},"reference-count":20,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"am","delay-in-days":353,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["IS220008"],"award-info":[{"award-number":["IS220008"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>After hemorrhage control, fluid resuscitation is the most important intervention for hemorrhage. Even skilled providers can find resuscitation challenging to manage, especially when multiple patients require care. In the future, attention\u2010demanding medical tasks like fluid resuscitation for hemorrhage patients may be reassigned to autonomous medical systems when availability of skilled human providers is limited, such as in austere military settings and mass casualty incidents. Central to this endeavor is the development and optimization of control architectures for physiological closed\u2010loop control systems (PCLCs). PCLCs can take many forms, from simple table look\u2010up methods to widely used proportional\u2013integral\u2013derivative or fuzzy\u2010logic control theory. Here, we describe the design and optimization of multiple adaptive resuscitation controllers (ARCs) that we have purpose\u2010built for the resuscitation of hemorrhaging patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Three ARC designs were evaluated that measured pressure\u2013volume responsiveness using different methodologies during resuscitation from which adapted infusion rates were calculated. These controllers were adaptive in that they estimated required infusion flow rates based on measured volume responsiveness. A previously developed hardware\u2010in\u2010loop test platform was used to evaluate the ARCs implementations across several hemorrhage scenarios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After optimization, we found that our purpose\u2010built controllers outperformed traditional control system architecture as embodied in our previously developed dual\u2010input fuzzy\u2010logic controller.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Future efforts will focus on engineering our purpose\u2010built control systems to be robust to noise in the physiological signal coming to the controller from the patient as well as testing controller performance across a range of test scenarios and in vivo.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17377","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T18:44:45Z","timestamp":1681843485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Adaptive closed\u2010loop resuscitation controllers for hemorrhagic shock resuscitation"],"prefix":"10.1111","volume":"63","author":[{"given":"Saul J.","family":"Vega","sequence":"first","affiliation":[{"name":"Organ Support and Automation Technologies Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-3846","authenticated-orcid":false,"given":"David","family":"Berard","sequence":"additional","affiliation":[{"name":"Organ Support and Automation Technologies Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9337-185X","authenticated-orcid":false,"given":"Guy","family":"Avital","sequence":"additional","affiliation":[{"name":"Trauma &amp; Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces  Ramat\u2010Gan Israel"},{"name":"Division of Anesthesia, Intensive Care &amp; Pain Management Tel\u2010Aviv Sourasky Medical Center  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3516-2766","authenticated-orcid":false,"given":"Evan","family":"Ross","sequence":"additional","affiliation":[{"name":"Blood and Shock Resuscitation Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0293-4937","authenticated-orcid":false,"given":"Eric J.","family":"Snider","sequence":"additional","affiliation":[{"name":"Organ Support and Automation Technologies Group, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy120"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2020.106393"},{"issue":"4","key":"e_1_2_9_4_1","first-page":"S289","article-title":"Closed\u2010loop strategies for patient care systems","volume":"64","author":"Pauldine R","year":"2008","journal-title":"J Trauma"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12071168"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering9090420"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering9080373"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/pr10112301"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1955.35.1.123"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/shk.0b013e31804a5791"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12060979"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057-1976\/ac6196"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1142\/9789812389701_0029"},{"issue":"8","key":"e_1_2_9_14_1","first-page":"7","article-title":"Adaptive Cruise Control using Fuzzy Logic","volume":"3","author":"Panse P","year":"2015","journal-title":"Int J Digital Appl Contemp Res"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asr.2020.02.022"},{"key":"e_1_2_9_16_1","unstructured":"AlkholyEMN AboutablAE HaggagMH.A proposed fuzzy model for diseases diagnosis.2020."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200207-777CP"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2019.2915526"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01143186"},{"key":"e_1_2_9_20_1","unstructured":"14:00\u201317:00.IEC 60601\u20101\u201010:2007. [Internet]. ISO. [cited 2022 Mar 25]. Available from:https:\/\/www.iso.org\/cms\/render\/live\/en\/sites\/isoorg\/contents\/data\/standard\/04\/41\/44104.html"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40696-016-0029-0"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/am-pdf\/10.1111\/trf.17377","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.17377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T12:50:21Z","timestamp":1709124621000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.17377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":20,"journal-issue":{"issue":"S3","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1111\/trf.17377"],"URL":"https:\/\/doi.org\/10.1111\/trf.17377","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2022-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}