Closed-Loop Control of Consciousness During Lung Transplantation: An Observational Study

Objective: To determine if propofol infusion can be steered automatically by using bispectral index (BIS) as a controller during lung transplantation. Design: A prospective study of patients undergoing lung transplantation. Setting: University hospital. Participants: Twenty consecutive patients sche...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2008-08, Vol.22 (4), p.611-615
Main Authors: Liu, Ngai, MD, Chazot, Thierry, MD, Trillat, Bernard, MSc, Michel-Cherqui, Mireille, MD, Marandon, Jean Yves, MD, Law-Koune, Jean-Dominique, MD, Rives, Bertrand, MD, Fischler, Marc, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anesthesia & Perioperative Care
Anesthesia, Closed-Circuit - methods
anesthetics
Consciousness - drug effects
Consciousness - physiology
Critical Care
drug-delivery system
Electroencephalography - methods
Female
Humans
intravenous
lung transplantation
Lung Transplantation - methods
Male
Middle Aged
propofol
Propofol - administration & dosage
Prospective Studies
Time Factors
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Summary:Objective: To determine if propofol infusion can be steered automatically by using bispectral index (BIS) as a controller during lung transplantation. Design: A prospective study of patients undergoing lung transplantation. Setting: University hospital. Participants: Twenty consecutive patients scheduled for bilateral (n = 14) or single (n = 6) lung transplantation. Interventions: The goal of the closed-loop administration of propofol was to maintain the BIS value between 40 and 60 during the maintenance phase. The remifentanil infusion was adjusted according to standard clinical practice. Measurements and Main Results: The closed-loop system was able to provide anesthesia maintenance for all patients. Cardiopulmonary bypass was used in 5 patients, and 14 patients received a thoracic epidural catheter. The BIS value was maintained between 40 and 60 during 84% ± 16% of the maintenance phase. Eleven patients were extubated in the operating room, and 1 patient needed reintubation. Conclusion: Closed-loop control of consciousness by a computer during lung transplantation is clinically feasible.
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2008.04.022