Anaesthesia is a multivariable problem where a combination of drugs are used to induce desired hypnotic, analgesia and immobility states. The automation of anaesthesia may improve the safety and cost-effectiveness of anaesthesia. However, the realization of a safe and reliable multivariable closed-loop control of anaesthesia is yet to be achieved due to a manifold of challenges. In this paper, several significant challenges in automation of anaesthesia are discussed, namely model uncertainty, controlled variables, closed-loop application and dependability. The increasingly reliable measurement device, robust and adaptive controller, and better fault tolerance strategy are paving the way for automation of anaesthesia.
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http://dx.doi.org/10.1007/s10877-014-9590-6 | DOI Listing |
Intensive Care Med
January 2025
Global Health Research Group in Acquired Brain and Spine Injuries, Cambridge, UK.
Background: Invasive systems are commonly used for monitoring intracranial pressure (ICP) in traumatic brain injury (TBI) and are considered the gold standard. The availability of invasive ICP monitoring is heterogeneous, and in low- and middle-income settings, these systems are not routinely employed due to high cost or limited accessibility. The aim of this consensus was to develop recommendations to guide monitoring and ICP-driven therapies in TBI using non-invasive ICP (nICP) systems.
View Article and Find Full Text PDFMagnes Res
January 2025
Department of Anaesthesiology & Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea, Department of Anaesthesiology & Pain Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
Although intraoperative magnesium sulphate administration has various advantages, its influence on the occurrence of postoperative acute kidney injury (AKI) remains unclear, particularly in patients undergoing robot-assisted radical prostatectomy (RARP). The steep Trendelenburg position and a high intra-abdominal pressure can render patients susceptible to AKI after surgery. This study aimed to evaluate the effects of intraoperative magnesium sulphate administration on postoperative AKI in patients who underwent RARP.
View Article and Find Full Text PDFShock
January 2025
Department of Anesthesiology, The University of Texas Medical Branch, Galveston, Texas.
Introduction: The understanding of the interaction of closed-loop control of ventilation and oxygenation, specifically fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP), and fluid resuscitation after burn injury and acute lung injury from smoke inhalation is limited. We compared the effectiveness of FiO2, PEEP, and ventilation adjusted automatically using adaptive support ventilation (ASV) and decision support fluid resuscitation based on urine output in a clinically relevant conscious ovine model of lung injury secondary to combined smoke inhalation and major burn injury.
Methods: Sheep were subjected to burn and smoke inhalation injury under deep anesthesia and analgesia.
A A Pract
January 2025
Department of Psychology, Neuropsychology Lab, CarlVon Ossietzky Universität, Oldenburg, Germany.
An elderly patient with renal cell carcinoma underwent a robotic nephrectomy. After an uneventful intraoperative period, soon after extubation she developed generalized seizures and was diagnosed with posterior reversible encephalopathy syndrome (PRES) on neuroimaging. Management included antiepileptic and antihypertensive therapies, necessitating intensive care and neurorehabilitation.
View Article and Find Full Text PDFResusc Plus
January 2025
Emergency Medical Services, Capital Region of Denmark, Ballerup, Denmark.
Unlabelled: Out-of-hospital cardiac arrest (OHCA) remains a critical health concern, where prompt access to automated external defibrillators (AEDs) significantly improves survival. This scoping review broadly investigates the feasibility and impact of dronedelivered AEDs for OHCA response.
Methods: PubMed, Cochrane, and Web of Science were searched from inception to August 6, 2024, with eligibility broadly including empirical data.
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