BIOSIGNAL 2010, extended abstract

Models of the Renin-Angiotensin and Baroreceptor Reflex

Systems for Blood Pressure Regulation
Ciprian Sandu, Paul Dan Cristea
Biomedical Engineering Center, University "Politehnica" of Bucharest, Romania
chip.sandu@gmail.com

1 Introduction
Introducing automatic control in the blood pressure regulation for post cardiac surgery
patients reduces the mortality, as well as the costs and the workload of healthcare staff.
Previous studies have proposed models of patient blood pressure regulation system, models
that have been successfully developed and implemented. Such models comprise several parts:
the drug response model of Slate et al. (1980), the models for the two internal reflexes
mentioned in the title, and include the effects of random disturbances. This paper focuses on
new and improved models for these two reflexes.

2 Methods
Complex natural feedback control systems in the human body are often disrupted during
cardiac surgery. Thus, for the regulation of mean arterial pressure (MAP) in post cardiac
surgery patients, intravenous administration of a fast-acting vasodilator – sodium
nitroprusside (SNP) – is necessary.
The components of a realistic patient model are: a drug response model, models for
internal reflexes - Renin Angiotensin System (RAS) and Baroreceptor Reflex System (BRS),
measurement dynamics and noise (caused by the movements of the patient, by his respiration,
etc.).
This work employs the model of Slate et al. (1980) for drug response:

(1)

where ΔPd(s) is a change in MAP (mmHg) and I(s) is the infusion rate of SNP (ml h -1), K
(mmHg/(ml h-1)) is a measure of the sensitivity of a patient in responding to the uptake of
SNP; a higher absolute value of K reflects higher sensitivity. α gives the fraction of SNP
available for recirculation after initial absorption. Ti is the initial transport delay – the time of
to transport the drug from the injection site to the effector’s site, Tc is the recirculation
transport delay and τ is the system time constant.

The role of RAS is to alter the total peripheral resistance of arterioles through a series of
chemical reactions and hence increase blood pressure. The typical range of threshold for
activation of RAS is between 70 and 75 mmHg. In this work the average value of 72 mmHg
has been used.

The BRS is modeled based on the theoretical response curve of MAP due to BRS alone
following an increase of MAP.
A sudden rise of MAP causes the baroreceptor reflex to respond so that it approaches the
value before the disturbance.
 BIOSIGNAL 2010, extended abstract
3 Results
Based on the models of RAS and BRS proposed by Hahn and Lee, this paper develops new
models for the two reflexes. A comparison between the three model responses for RAS is
shown in figure 1 (Simulink was the tool used for the simulations):

Fig 1. The responses of the three RAS models (Hahn, Lee and the proposed model) for a
step reference change from 130 mmHg to: (a) 100 mmHg, (b) 80 mmHg, and respectively (c)
70 mmHg .

4 Discussion
Hahn’s and Lee’s models become active before the reach of the known natural 72 mmHg
threshold, while the proposed model becomes active only after crossing it. Actually, Hahn‘s
model has no threshold whatsoever, Lee’s model partially improves this drawback, whereas
our model goes further in this direction.

5 Conclusions
Further studies on modeling and control of blood pressure are needed for the common
practice of multiple drug infusion, in order to regulate the total peripheral resistance and the
cardiac output in post cardiac surgery patients. Therefore even more advanced models must
be studied.

References

[1] H.W. Lee, S. Lakshminarayanan, G.P. Rangaiah (2005). Models and Simple
Controllers for Blood Pressure Regulation in Post Cardiac Surgery Patiens. Journal of
The Institution of Engineers, Singapore. Vol. 45 Issue 6

[2] Arthur C. Guyton, John E. Hall (2006). Textbook of Medical Physiology –

Eleventh Edition.