Vasopressor Control Module Development and Integration into the Hardware-in-Loop Automated Testbed for Resuscitation Controller Evaluation

Introduction: Patients in hemorrhagic shock who are unresponsive to fluid administration can urgently require vasopressor therapy. However, manual vasopressor titration in mass casualty or resource-limited settings can be arduous, increasing the risk of under- or over-treatment. Closed-loop vasopressor adaptive resuscitation controllers (V-ARCs) offer a potential solution, but their development is hindered by the lack of realistic and adaptable laboratory test platforms. To solve this problem, we developed a Vasopressor Control Module (VCM) for a hardware-in-loop automated testbed for resuscitation controllers (HATRC) to enable the systematic evaluation of V-ARCs. Methods and Results The VCM’s design was informed by vasopressor administration data captured in a hemorrhagic shock swine model, which revealed four key physiological variables that defined the hemodynamic response to vasopressor infusion: lag time, real response, overshoot, and pressure-time responsiveness. The incorporation of these variables enabled the VCM to replicate physiological variability, dose-dependent responsiveness, and noise conditions representative of the clinical setting. The platform was validated by preliminarily comparing multiple V-ARC designs under different testing conditions and successfully differentiating their performance. Conclusions This work establishes a flexible, physiologically grounded platform for vasopressor controller development, reducing dependence on animal testing while enabling rapid and robust controller evaluation. Future work will expand physiological modeling, incorporate additional hemodynamic variables, and support multiagent resuscitation.