On the use of multivariable piecewise-linear models for predicting human response to anesthesia

The standard modeling paradigm used to describe the relationship between input anesthetic agents and output patient endpoint variables are single-input single-output pharmacokinetic-pharmacodynamic (PK-PD) compartment models. In this paper, we propose the use of multivariable piecewise-linear models to describe the relations between inputs that include anesthesia, surgical stimuli and disturbances to a variety of patient output variables. Subspace identification methods are applied to clinical data to construct the models. A comparison of predicted and measured responses is completed, which includes predictions from PK-PD models, and piecewise-linear time-invariant models.