Advanced search
1 file | 4.60 MB Add to list

A comparison of propofol-to-BIS post-operative intensive care sedation by means of target controlled infusion, Bayesian-based and predictive control methods : an observational, open-label pilot study

Author
Organization
Abstract
Purpose: We evaluated the feasibility and robustness of three methods for propofol-to-bispectral index (BIS) post-operative intensive care sedation, a manually-adapted target controlled infusion protocol (HUMAN), a computer-controlled predictive control strategy (EPSAC) and a computer-controlled Bayesian rule-based optimized control strategy (BAYES). Methods: Thirty-six patients undergoing short lasting sedation following cardiac surgery were included to receive propofol to maintain a BIS between 40 and 60. Robustness of control for all groups was analysed using prediction error and spectrographic analysis. Results: Although similar time courses of measured BIS were obtained in all groups, a higher median propofol effect-site concentration (CePROP) was required in the HUMAN group compared tothe BAYES and EPSACgroups. The time course analysis of the remifentanil effect-site concentration (CeREMI) revealed a significant increase in CeREMI in the EPSAC group compared to BAYES and HUMAN during the case. Although similar bias and divergence in control was found in all groups, larger control inaccuracy was observed in HUMAN versus EPSAC and BAYES. Spectrographic analysis of the system behavior shows that BAYES covers the largest spectrum of frequencies, followed by EPSAC and HUMAN. Conclusions: Both computer-based control systems are feasible to be used during ICU sedation with overall tighter control than HUMAN and even with lower required CePROP. EPSAC control required higher CeREMI than BAYES or HUMAN to maintain stable control. Clinical trial number: NCT00735631.
Keywords
Propofol, Bispectral index, Closed-loop, Intensive care sedation, CLOSED-LOOP CONTROL, BISPECTRAL INDEX, ANESTHESIA, PHARMACOKINETICS, SYSTEM, PHARMACODYNAMICS, REMIFENTANIL, FEASIBILITY, INDUCTION, DEPTH

Downloads

  • 8627162.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 4.60 MB

Citation

Please use this url to cite or link to this publication:

MLA
Neckebroek, Martine et al. “A Comparison of propofol-to-BIS Post-operative Intensive Care Sedation by Means of Target Controlled Infusion, Bayesian-based and Predictive Control Methods : an Observational, Open-label Pilot Study.” JOURNAL OF CLINICAL MONITORING AND COMPUTING 33.4 (2019): 675–686. Print.
APA
Neckebroek, M., Ionescu, C.-M., van Amsterdam, K., De Smet, T., De Baets, P., Decruyenaere, J., De Keyser, R., et al. (2019). A comparison of propofol-to-BIS post-operative intensive care sedation by means of target controlled infusion, Bayesian-based and predictive control methods : an observational, open-label pilot study. JOURNAL OF CLINICAL MONITORING AND COMPUTING, 33(4), 675–686.
Chicago author-date
Neckebroek, Martine, Clara-Mihaela Ionescu, K van Amsterdam, T De Smet, Patrick De Baets, Johan Decruyenaere, Robain De Keyser, and Michel Struys. 2019. “A Comparison of propofol-to-BIS Post-operative Intensive Care Sedation by Means of Target Controlled Infusion, Bayesian-based and Predictive Control Methods : an Observational, Open-label Pilot Study.” Journal of Clinical Monitoring and Computing 33 (4): 675–686.
Chicago author-date (all authors)
Neckebroek, Martine, Clara-Mihaela Ionescu, K van Amsterdam, T De Smet, Patrick De Baets, Johan Decruyenaere, Robain De Keyser, and Michel Struys. 2019. “A Comparison of propofol-to-BIS Post-operative Intensive Care Sedation by Means of Target Controlled Infusion, Bayesian-based and Predictive Control Methods : an Observational, Open-label Pilot Study.” Journal of Clinical Monitoring and Computing 33 (4): 675–686.
Vancouver
1.
Neckebroek M, Ionescu C-M, van Amsterdam K, De Smet T, De Baets P, Decruyenaere J, et al. A comparison of propofol-to-BIS post-operative intensive care sedation by means of target controlled infusion, Bayesian-based and predictive control methods : an observational, open-label pilot study. JOURNAL OF CLINICAL MONITORING AND COMPUTING. 2019;33(4):675–86.
IEEE
[1]
M. Neckebroek et al., “A comparison of propofol-to-BIS post-operative intensive care sedation by means of target controlled infusion, Bayesian-based and predictive control methods : an observational, open-label pilot study,” JOURNAL OF CLINICAL MONITORING AND COMPUTING, vol. 33, no. 4, pp. 675–686, 2019.
@article{8585837,
  abstract     = {Purpose: We evaluated the feasibility and robustness of three methods for propofol-to-bispectral index (BIS) post-operative intensive care sedation, a manually-adapted target controlled infusion protocol (HUMAN), a computer-controlled predictive control strategy (EPSAC) and a computer-controlled Bayesian rule-based optimized control strategy (BAYES).
Methods: Thirty-six patients undergoing short lasting sedation following cardiac surgery were included to receive propofol to maintain a BIS between 40 and 60. Robustness of control for all groups was analysed using prediction error and spectrographic analysis.
Results: Although similar time courses of measured BIS were obtained in all groups, a higher median propofol effect-site concentration (CePROP) was required in the HUMAN group compared tothe BAYES and EPSACgroups. The time course analysis of the remifentanil effect-site concentration (CeREMI) revealed a significant increase in CeREMI in the EPSAC group compared to BAYES and HUMAN during the case. Although similar bias and divergence in control was found in all groups, larger control inaccuracy was observed in HUMAN versus EPSAC and BAYES. Spectrographic analysis of the system behavior shows that BAYES covers the largest spectrum of frequencies, followed by EPSAC and HUMAN.
Conclusions: Both computer-based control systems are feasible to be used during ICU sedation with overall tighter control than HUMAN and even with lower required CePROP. EPSAC control required higher CeREMI than BAYES or HUMAN to maintain stable control.
Clinical trial number: NCT00735631.},
  author       = {Neckebroek, Martine and Ionescu, Clara-Mihaela and van Amsterdam, K and De Smet, T and De Baets, Patrick and Decruyenaere, Johan and De Keyser, Robain and Struys, Michel},
  issn         = {1387-1307},
  journal      = {JOURNAL OF CLINICAL MONITORING AND COMPUTING},
  keywords     = {Propofol,Bispectral index,Closed-loop,Intensive care sedation,CLOSED-LOOP CONTROL,BISPECTRAL INDEX,ANESTHESIA,PHARMACOKINETICS,SYSTEM,PHARMACODYNAMICS,REMIFENTANIL,FEASIBILITY,INDUCTION,DEPTH},
  language     = {eng},
  number       = {4},
  pages        = {675--686},
  title        = {A comparison of propofol-to-BIS post-operative intensive care sedation by means of target controlled infusion, Bayesian-based and predictive control methods : an observational, open-label pilot study},
  url          = {http://dx.doi.org/10.1007/s10877-018-0208-2},
  volume       = {33},
  year         = {2019},
}

Altmetric
View in Altmetric
Web of Science
Times cited: