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Lessons learned from closed loops in engineering: towards a multivariable approach regulating depth of anaesthesia

Clara-Mihaela Ionescu (UGent), Ioana Nascu (UGent) and Robain De Keyser (UGent)
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Abstract
In this paper is presented a brief state of art regarding the multivariable formulation for controlling the depth of anaesthesia by means of two intravenously administrated drugs, i.e. propofol and remifentanil. In a feasibility study of determining a suitable variable to quantify analgesia levels in patients undergoing cardiac surgery, the bispectral index and an electromyogram-based surrogate variable are proposed as the controlled variables. The study is carried on in the context of implementing a multivariable predictive control algorithm. The simulation results show that such a paradigm is feasible, although it does not guarantee perfect knowledge of the analgesia level-in other words, the variable is not validated against typical evaluations of the pain levels (e.g. clinical scores).
Keywords
DRUG-INTERACTIONS, BISPECTRAL INDEX, PROPOFOL, REMIFENTANIL, PHARMACODYNAMICS, MODEL, PHARMACOKINETICS, SIMULATION, DELIVERY, SYSTEMS, Anaesthesia, Analgesia, Predictive control, Multivariable control

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Chicago
Ionescu, Clara-Mihaela, Ioana Nascu, and Robain De Keyser. 2014. “Lessons Learned from Closed Loops in Engineering: Towards a Multivariable Approach Regulating Depth of Anaesthesia.” Journal of Clinical Monitoring and Computing 28 (6): 537–546.
APA
Ionescu, C.-M., Nascu, I., & De Keyser, R. (2014). Lessons learned from closed loops in engineering: towards a multivariable approach regulating depth of anaesthesia. JOURNAL OF CLINICAL MONITORING AND COMPUTING, 28(6), 537–546.
Vancouver
1.
Ionescu C-M, Nascu I, De Keyser R. Lessons learned from closed loops in engineering: towards a multivariable approach regulating depth of anaesthesia. JOURNAL OF CLINICAL MONITORING AND COMPUTING. 2014;28(6):537–46.
MLA
Ionescu, Clara-Mihaela, Ioana Nascu, and Robain De Keyser. “Lessons Learned from Closed Loops in Engineering: Towards a Multivariable Approach Regulating Depth of Anaesthesia.” JOURNAL OF CLINICAL MONITORING AND COMPUTING 28.6 (2014): 537–546. Print.
@article{4343538,
  abstract     = {In this paper is presented a brief state of art regarding the multivariable formulation for controlling the depth of anaesthesia by means of two intravenously administrated drugs, i.e. propofol and remifentanil. In a feasibility study of determining a suitable variable to quantify analgesia levels in patients undergoing cardiac surgery, the bispectral index and an electromyogram-based surrogate variable are proposed as the controlled variables. The study is carried on in the context of implementing a multivariable predictive control algorithm. The simulation results show that such a paradigm is feasible, although it does not guarantee perfect knowledge of the analgesia level-in other words, the variable is not validated against typical evaluations of the pain levels (e.g. clinical scores).},
  author       = {Ionescu, Clara-Mihaela and Nascu, Ioana and De Keyser, Robain},
  issn         = {1387-1307},
  journal      = {JOURNAL OF CLINICAL MONITORING AND COMPUTING},
  keyword      = {DRUG-INTERACTIONS,BISPECTRAL INDEX,PROPOFOL,REMIFENTANIL,PHARMACODYNAMICS,MODEL,PHARMACOKINETICS,SIMULATION,DELIVERY,SYSTEMS,Anaesthesia,Analgesia,Predictive control,Multivariable control},
  language     = {eng},
  number       = {6},
  pages        = {537--546},
  title        = {Lessons learned from closed loops in engineering: towards a multivariable approach regulating depth of anaesthesia},
  url          = {http://dx.doi.org/10.1007/s10877-013-9535-5},
  volume       = {28},
  year         = {2014},
}

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