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doctoral thesis

Optimal control of mass transfer in peritoneal dialysis

Mastalli, Diego  
2006

The aim of this work is to set up mathematical models and numerical methods to investigate the mass transfer process occurring during the peritoneal dialysis (PD) therapy. More precisely the final goal is the set up of tools to find for each patient submitted to PD the best therapy profile to purify blood and remove water from the patients. First, we build up specific mathematical models to represent the physical phenomena we are interested in. As discussed in chapter 1, starting from the Kedem-Katchalsky equations, we end up with a systems of nonlinear ordinary differential equations describing the various aspects of the physical problem. Then, we propose a method based on nonlinear programming techniques to solve the inverse problem arising from the need to assess the peritoneal membrane characteristics which are not directly measurable on the patient. Thanks to its flexibility we are able to support the main standard tests nowadays in use to assess the kinetic properties of the peritoneum. We devise a suitable parametrization of the control function (DPD Dynamic Peritoneal Dialysis) that allows to improve the standard PD profiles with a larger set of treatments. Then we propose an optimization algorithm to improve the PD efficiency. Moreover, in the framework of control theory, we devise an algorithm based on the maximum principle of Pontryagin for switched systems to investigate deeply the PD optimal control problem. Afterwards we carry out numerical simulations, investigating the main inputs influencing the peritoneal dialysis efficiency. Specifically we show an extensive comparison between the APD (Automated Peritoneal Dialysis) and DPD (Dynamic Peritoneal Dilaysis) in order to assess the conditions under which DPD allows to improve the PD performance. Then a numerical investigation based on the algorithm devised for switched systems is carried out to assess the adequacy of DPD. Moreover we set up a procedure to reach an efficiency target and minimize the patient's exposure to glucose in order to improve the PD biocompatibility. Finally, we present the validation results of the mathematical model in order to verify its accuracy. A comparison between the APD and DPD is presented. Moreover we carry out a statistical analysis to assess the error distribution related to the most relevant quantities in order to evaluate strengths and weaknesses of this model and to identify the needs for a further improvement.

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Type
doctoral thesis
DOI
10.5075/epfl-thesis-3461
Author(s)
Mastalli, Diego  
Advisors
Quarteroni, Alfio  
Jury

Thomas Mountford, Marco Picasso, Jean-Pierre Wauters, Paolo Zunino

Date Issued

2006

Publisher

EPFL

Publisher place

Lausanne

Public defense year

2006-03-09

Thesis number

3461

Total of pages

155

Subjects

peritoneal dialysis

•

dialysate

•

steady state

•

mass transfer

•

diffusion

•

advection

•

Pyle-Popvic model

•

three pore model

•

clearance

•

fluid removal

•

parameter identification

•

nonlinear programming

•

optimal control

•

injection-dwell-extraction profile

•

drain profile

•

dynamic peritoneal dialysis (DPD)

•

automated peritoneal dialysis (APD)

•

switched system

•

Pontryagin maximum principle

•

dialyse péritonéale

•

dialysate

•

état stationnaire

•

transfert de masse

•

diffusion

•

transport

•

modèle de Pyle-Popvic

•

modèle trois pore

•

déblaiement

•

extraction de fluide

•

identification des paramètres

•

programmation non-linéaire

•

contrôle optimal

•

profil d'injection-pause-extraction

•

profil de drainage

•

dialyse péritonéale dynamique (DPD)

•

dialyse péritonéale automatique (APD) système à commutation

•

principe de maximum de Pontryagin

EPFL units
CMCS  
Faculty
SB  
Section
SB-SMA  
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/221676
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