Fig. 1.

a System configuration and data flow for the automatized closed-loop control of mechanical ventilation. Blue arrows indicate signal flow to the controller (afferent signals) and red arrows indicate signal flow from the controller to steer the mechanical ventilation and norepinephrine infusion (efferent signals). Adapted and reproduced with permission from [8]. b Closed-loop mechanical ventilation using the open lung approach (OLA). A brief opening phase is used to recruit previously collapsed alveoli and is followed by identification of the critical PEEP value below which lung derecruitment occurs (closing phase). Lung recruitment is repeated (reopening) with the PEEP value set 2 cm H₂O above the closing PEEP, followed by mechanical ventilation controlled by closed-loop physiological feedback algorithms (ventilation phase). PIP peak inspiratory pressure, PEEP positive end-expiratory pressure