학술논문

Closed-Loop Control of Anesthesia: Survey on Actual Trends, Challenges and Perspectives
Document Type
Periodical
Source
IEEE Access Access, IEEE. 8:206264-206279 2020
Subject
Aerospace
Bioengineering
Communication, Networking and Broadcast Technologies
Components, Circuits, Devices and Systems
Computing and Processing
Engineered Materials, Dielectrics and Plasmas
Engineering Profession
Fields, Waves and Electromagnetics
General Topics for Engineers
Geoscience
Nuclear Engineering
Photonics and Electrooptics
Power, Energy and Industry Applications
Robotics and Control Systems
Signal Processing and Analysis
Transportation
Drugs
Automation
Clinical trials
Anesthesia
Control systems
Regulation
Safety
Closed-loop control
drug-delivery control
anesthesia
(semi-)automated anesthesia delivery
cyber physical medical systems
decision support systems
adaptive control
Language
ISSN
2169-3536
Abstract
Automation empowers self-sustainable adaptive processes and personalized services in many industries. The implementation of the integrated healthcare paradigm built on Health 4.0 is expected to transform any area in medicine due to the lightning-speed advances in control, robotics, artificial intelligence, sensors etc. The two objectives of this article, as addressed to different entities, are: i) to raise awareness throughout the anesthesiologists about the usefulness of integrating automation and data exchange in their clinical practice for providing increased attention to alarming situations, ii) to provide the actualized insights of drug-delivery research in order to create an opening horizon towards precision medicine with significantly improved human outcomes. This article presents a concise overview on the recent evolution of closed-loop anesthesia delivery control systems by means of control strategies, depth of anesthesia monitors, patient modelling, safety systems, and validation in clinical trials. For decades, anesthesia control has been in the midst of transformative changes, going from simple controllers to integrative strategies of two or more components, but not achieving yet the breakthrough of an integrated system. However, the scientific advances that happen at high speed need a modern review to identify the current technological gaps, societal implications, and implementation barriers. This article provides a good basis for control research in clinical anesthesia to endorse new challenges for intelligent systems towards individualized patient care. At this connection point of clinical and engineering frameworks through (semi-) automation, the following can be granted: patient safety, economical efficiency, and clinicians’ efficacy.