闭环麻醉:当代外科手术医学的基础和应用
Sean Coeckelenbergh1,2, Sebastian Boelefahr3, Brenton Alexander4
1Department of Anesthesiology and Intensive Care, Hôpitaux Universitaires Paris-Saclay, Université Paris-Saclay, Hôpital Paul-Brousse, Assistance Publique Hôpitaux de Paris, Villejuif, France. sean.coeckelenbergh@gmail.com.
Journal of clinical monitoring and computing
|January 6, 2024
概括
闭环麻醉系统通过稳定变量和减少从业者的工作量来提高患者的结果. 持续的人类监督对于安全和最佳的患者护理至关重要.
科学领域:
- 麻醉学 麻醉学
- 医疗自动化 医疗自动化
- 控制系统工程 控制系统工程
背景情况:
- 闭环系统使用反进行自动控制,旨在提高麻醉护理的稳定性并减少从业人员的工作量.
- 超过20年的临床研究表明,闭环系统在稳定变量,减少工作量和管理治疗方面优于手动控制.
- 目前的研究探讨了同时独立的闭环系统,其中一项研究显示了手术后认知功能的改善.
研究的目的:
- 审查闭环麻醉系统的已知好处和未来潜力.
- 突出人类监督在自动化麻醉交付的重要性.
- 讨论向多个输入,多个输出 (MIMO) 闭环系统的演变.
主要方法:
- 关于闭环麻醉系统的临床研究和研究的审查.
- 对电脑图,血压和流体响应等稳定变量系统性能的分析.
- 讨论闭环技术在麻醉中的当前和未来应用.
主要成果:
- 闭环系统在稳定单个变量和减少从业人员工作量方面始终表现出优于手动控制的优势.
- 具体的应用包括使用propofol处理的脑电图,使用血管压缩剂的血压,以及由动态预测器引导的流体治疗.
- 最近的进展包括多个同时独立的闭环系统,在术后认知功能障碍方面具有证明的临床益处.
结论:
- 闭环麻醉系统在稳定性,工作量减少和遵守协议方面提供了显著的优势,最终旨在改善患者的治疗结果.
- 尽管有进展,但训练有素的从业人员对于保持情况意识和必要时介入至关重要.
- 未来的系统可能将多个输入和输出集成为全面的麻醉管理,但人类监督仍然是不可或缺的.
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