Clinical evaluation of an automatic blood pressure controller during cardiac surgery

During surgery, computers can be of great use to support the anesthesiologist in providing task automation. In this paper we describe a closed loop blood pressure controller and show the results of its clinical evaluation. The controller is based on a simple and robust Proportional-Integral controll...

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Bibliographic Details
Published in:Journal of clinical monitoring 1997-07, Vol.13 (4), p.261-268
Main Authors: MEIJERS, R. H. A. M, SCHMARTZ, D, CANTRAINE, F. R. L, BARVAIS, L, D'HOLLANDER, A. A, BLOM, J. A
Format: Article
Language:English
Subjects:
Algorithms
Analog-Digital Conversion
Aortic Valve - surgery
Automation
Biological and medical sciences
Blood Pressure - drug effects
Blood Pressure Monitors
Cardiac Surgical Procedures - instrumentation
Cardiopulmonary Bypass
Computer Systems
Coronary Artery Bypass
Equipment Design
Evaluation Studies as Topic
Expert Systems
Female
Hemorheology
Humans
Infusion Pumps
Male
Medical sciences
Mitral Valve - surgery
Monitoring, Intraoperative - instrumentation
Nitroprusside - administration & dosage
Nitroprusside - therapeutic use
Signal Processing, Computer-Assisted
Software
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Vasodilator Agents - administration & dosage
Vasodilator Agents - therapeutic use
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Summary:During surgery, computers can be of great use to support the anesthesiologist in providing task automation. In this paper we describe a closed loop blood pressure controller and show the results of its clinical evaluation. The controller is based on a simple and robust Proportional-Integral controller and a supervising, rule based, expert system. Adaptive control is necessary because the sensitivity of the patients to sodium nitroprusside varies over a wide range. Thirty-three clinical tests during cardiac surgery, including the cardiopulmonary bypass phase, were performed. On average the controller was in automatic mode for 90.6 +/- 9.6% of the time. The performance during automatic control showed the mean arterial pressure to be within 10 mmHg of the setpoint for 71.4 +/- 15.5% of the time. The average absolute distance to the setpoint was 8.1 +/- 7.2 mmHg. The overall performance of the controller was noted as very satisfactory by the anesthesiologists.
ISSN:0748-1977
2214-7330
DOI:10.1023/A:1007389631055