ArticleBMC anesthesiology2017
Computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in endotoxin-induced shock.
Article in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Population Pharmacokinetic Modelling of Norepinephrine in Healthy Volunteers Prior to and During General Anesthesia.Clinical pharmacokinetics · 2024Trial
- Automated closed-loop versus manually controlled norepinephrine infusion in patients undergoing intermediate- to high-risk abdominal surgery: a randomised controlled trial.British journal of anaesthesia · 2021Trial
- Automated hemodynamic resuscitation system for computer-controlled norepinephrine, vasopressin, and fluid therapy in endotoxin-induced shock: a feasibility and physiological proof-of-concept study.Intensive care medicine experimental · 2026Article
- Automated hemodynamic management system for the prevention of hypotension and cardiac output reduction during general anesthesia: preclinical experimental validation.Journal of anesthesia · 2026Article
- Computer-controlled closed-loop norepinephrine infusion system for automated control of mean arterial pressure in dogs under isoflurane-induced hypotension: a feasibility study.Frontiers in veterinary science · 2024Article
- Review
- A system theory based digital model for predicting the cumulative fluid balance course in intensive care patients.Frontiers in physiology · 2023Article
- Development of an automated closed-loop β-blocker delivery system to stably reduce myocardial oxygen consumption without inducing circulatory collapse in a canine heart failure model: a proof of concept study.Journal of clinical monitoring and computing · 2022Article
- Assessment of Dynamic Changes in Stressed Volume and Venous Return during Hyperdynamic Septic Shock.Journal of personalized medicine · 2022Article
- Performance of closed-loop resuscitation in a pig model of haemorrhagic shock with fluid alone or in combination with norepinephrine, a pilot study.Journal of clinical monitoring and computing · 2021Article
- Editorial: Fluid Therapy in Animals: Physiologic Principles and Contemporary Fluid Resuscitation Considerations.Frontiers in veterinary science · 2021Article
- Closed-Loop Control for Fluid Resuscitation: Recent Advances and Future Challenges.Frontiers in veterinary science · 2021Review
- Automated systems for perioperative goal-directed hemodynamic therapy.Journal of anesthesia · 2020Review
- Performance of closed-loop resuscitation of haemorrhagic shock with fluid alone or in combination with norepinephrine: an experimental study.Annals of intensive care · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHemodynamic resuscitation in septic shock requires aggressive fluid replacement and appropriate use of vasopressors to optimize arterial pressure (AP) and cardiac output (CO). Because responses to these drugs vary between patients and within patient over time, strict monitoring of patient condition and repetitive adjustment of drug dose are required. This task is time and labor consuming, and is associated with poor adherence to resuscitation guidelines. To overcome this issue, we developed a computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in septic shock, and evaluated the performance of the system in a canine model of endotoxin shock.
methodsOur system monitors AP, CO and central venous pressure, and computes arterial resistance (R), stressed blood volume (V) and Frank-Starling slope of left ventricle (S). The system controls R with noradrenaline (NA), and V with Ringer's acetate solution (RiA), thereby controlling AP and CO. In 4 dogs, AP and CO were measured invasively. In another 4 dogs, AP and CO were measured less invasively using clinically acceptable modalities, aiming to make the system clinically feasible. In all 8 dogs, endotoxin shock was induced by injecting Escherichia coli lipopolysaccharide, which significantly decreased AP from 95 (91-108) to 43 (39-45) mmHg, and CO from 112 (104-142) to 62 (51-73) ml·min
resultsOur system immediately started infusions of NA and RiA. Within 40 min, RiA increased V to target level, and NA maintained R at target level, while S was concomitantly increased. These resulted in restoration of AP to 70 (69-71) mmHg and CO to 130 (125-138) ml·min
conclusionsIn a canine model of endotoxin shock, our system automatically improved and maintained AP and CO at their target values with small performance error. Our system is potentially an attractive clinical tool for rescuing patients with septic shock.
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