Closed-loop control of blood pressure, ventilation, and anesthesia delivery

Closed-loop control systems have been in use for over 4,000 years, yet applications in medicine have developed only recently. When compared with manual control, closed-loop controllers for blood pressure, ventilation, and anesthesia delivery provide more rapid and more precise control of mean pressure, end-tidal CO2, and end-tidal anesthetic concentrations. Closed-loop control systems perform better in almost all situations. It must be remembered however, that the best anesthesiologist may perform better than the controller, particularly in his ability to anticipate clinical events which effect control. Although the convenience, precision of control, and immunity to distractions are reason enough to further pursue their development, their final application to clinical care will depend on the inclusion of appropriate safeguards and supervisory software algorithms to protect the systems from failure.