Conflicting interactions in multiple closed-loop controlled critical care Treatments: A hemorrhage resuscitation-intravenous propofol sedation case study
Conflicting interactions in multiple closed-loop controlled critical care Treatments: A hemorrhage resuscitation-intravenous propofol sedation case study
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多种闭环控制重症监护治疗中的冲突相互作用：出血复苏-静脉注射异丙酚镇静案例研究
DOI：
10.1016/j.bspc.2021.103268
复制
发表时间：
2022
影响因子：
5.1
通讯作者：
Hahn, Jin-Oh
中科院分区：
文献类型：
--
作者：
Yin, Weidi;Tivay, Ali;Kramer, George C.;Bighamian, Ramin;Hahn, Jin-Oh
重症监护治疗的闭环自动化有可能减少临床人员的工作量，同时保持护理质量。在现实世界的临床领域，重症患者会接受多种治疗。然而，现有的工作主要集中在孤立的个体治疗的闭环自动化上。这些单独的治疗循环如何相互作用尚未得到研究。这项工作的目的是通过出血复苏和静脉丙泊酚镇静的案例研究，深入了解重症监护治疗的安全性以及当对患者进行多种隔离和单独闭环控制的医疗治疗时潜在的有害冲突。为此，开发了危重患者的生理模型并进行了实验验证，以描述这些治疗的集体心血管和药理作用。然后，将孤立的、单独的闭环控制出血复苏和静脉丙泊酚镇静治疗同时应用于生理模型，并研究它们的交互行为。结果表明，（i）在选择治疗设定点时必须考虑一种治疗对另一种治疗的影响，以维持整体治疗的安全性，并且（ii）控制回路之间的信息共享可以提高各个治疗回路的功效和稳健性。总之，得出的结论是，出血复苏和静脉丙泊酚镇静治疗可能受益于设定点和循环水平的协调。该结论可以推广到广泛的多种闭环控制医疗。
Closed-loop automation of critical care therapy has the potential to reduce the workload of clinical personnel while maintaining the quality of care. In the real-world clinical arena, critically ill patients receive multiple medical treatments. However, existing body of work has predominantly focused on closed-loop automation of isolated individual treatments. How these individual treatment loops interact with each other has not been investigated. The goal of this work is to garner insights on the safety of critical care therapy and potential deleterious conflicts therein when multiple isolated and individually closed-loop controlled medical treatments act upon a patient, using a case study of hemorrhage resuscitation and intravenous propofol sedation. For this purpose, a physiological model of a critically ill patient was developed and experimentally validated to describe the collective cardiovascular and pharmacological effects of these treatments. Then, isolated and individually closed-loop controlled hemorrhage resuscitation and intravenous propofol sedation treatments were simultaneously applied to the physiological model and their interactive behavior was investigated. The results showed that (i) the influence of one treatment on the other must be taken into account in selecting treatment set point to maintain the safety of overall therapy, and that (ii) information sharing between control loops may enhance the efficacy and robustness of individual treatment loops. In sum, it was concluded that hemorrhage resuscitation and intravenous propofol sedation treatments may benefit from coordination both at the set point and the loop levels. The conclusion may generalize to a wide spectrum of multiple closed-loop controlled medical treatments.
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DOI：
10.1016/j.bpa.2008.08.001
发表时间：
2009-03-01
影响因子：
4.8
作者：
Lellouche, Francois;Brochard, Laurent
通讯作者：
Brochard, Laurent
DOI：
10.1186/s13054-015-0827-7
发表时间：
2015-03-19
期刊：
Critical care (London, England)
影响因子：
--
作者：
Rinehart J;Lilot M;Lee C;Joosten A;Huynh T;Canales C;Imagawa D;Demirjian A;Cannesson M
通讯作者：
Cannesson M
两种相互作用药物输注的协调半自适应闭环控制
DOI：
10.1002/acs.2832
发表时间：
2018
影响因子：
3.1
作者：
Xin Jin;Chang;S. Shipley;G. Dumont;J. Hahn
通讯作者：
J. Hahn
影响因子：
5.7
作者：
Eleveld, Douglas J.;Proost, Johannes H.;Struys, Michel M. R. F.
通讯作者：
Struys, Michel M. R. F.
影响因子：
4.2
作者：
Hawryluk, Gregory;Whetstone, William;Manley, Geoffrey
通讯作者：
Manley, Geoffrey