Spelling suggestions: "subject:"closedloop system"" "subject:"closed_loop system""
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Canonical forms for linear descriptor systems with variable coefficientsRath, W. 30 October 1998 (has links) (PDF)
We study linear descriptor systems with rectangular variable coefficient matrices.
Using local and global equivalence transformations we introduce normal and
condensed forms and get sets of characteristic quantities. These quantities allow us to
decide whether a linear descriptor system with variable coefficients is regularizable
by derivative and/or proportional state feedback or not. Regularizable by feedback
means for us that their exist a feedback which makes the closed loop system uniquely
solvable for every consistent initial vector.
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Utbildning i samband med övergång till hybrid closed loop insulinpumpbehandling : en kvalitativ studie med personer som har diabetes typ-1Daniela, Jansson, Linda, Wallen January 2022 (has links)
Bakgrund: Den snabba utvecklingen av avancerad diabetesteknik kräver god kunskap från diabetesteamet. Diabetessjuksköterskan ansvarar för utbildningen av ny teknologi med krav på säker och personcentrerad vård. Vid start av en hybrid closed loop insulinpumpbehandling inkluderar diabetessjuksköterskan generellt en representant från det företag som ansvarar för den avancerade insulinpumpen så att mottagaren ska få all teknisk information korrekt. Syfte: Syftet med studien var att beskriva hur vuxna personer med diabetes typ 1 (T1D) upplever utbildningen utifrån säker och personcentrerad vård vid övergång till en hybrid closed loop insulinpumpbehandling. Metod: Kvalitativ intervjustudie med en induktiv ansats med semistrukturerade frågor genomfördes med åtta personer med T1D som har startat med en hybrid closed loop insulinpumpbehandling under åren 2020–2021. Intervjuerna hölls via zoom och de spelades in, transkriberades ordagrant och analyserades med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier och åtta underkategorier. Huvudkategorierna var: Tekniken och livet, Tekniken och utbildningen samt Tekniken och det professionella stödet. Det förekom tre olika typer av utbildningar; halvdag, tre dagar och distansuppstart, där majoriteten av deltagarna upplevde att de mottagit den utbildning de behöver för att känna sig trygg med behandlingen, men där vikten av snar uppföljning betonas. Insulinpumpföretagets support och diabetesteamets stöd är väsentliga för upplevelsen av trygghet. Slutsats: Den avancerade teknik som finns att tillgå idag förbättrar livskvaliteten och leder till ökad trygghet och frihet men kräver praktisk övning och snar uppföljning hos diabetessjuksköterska för att vara förenad med säker och personcentrerad vård. / Background: The rapid development of advanced diabetes technology requires great knowledge from the diabetes team. The diabetes nurse specialist is responsible for the education of new technology with demands for safe and person-centered care. When starting a hybrid closed loop insulin pump treatment, the diabetes nurse generally includes a specialist from the current company that is responsible for the advanced item, so that the receiver of the insulin pump is ensured to get all technical information correctly. Aim: The aim of this study was to describe how adult persons with diabetes type 1 (T1D) experience the education from the intention of safe and person-centered care in connection with transmission to a hybrid closed loop insulin pump treatment. Method: Qualitative interview study with an inductive approach with semi structured interview questions were conducted with eight persons with T1D who have started with a closed loop insulin pump treatment during the years of 2020 and 2021. The interviews took place via zoom and were recorded, transcribed verbatim and analyzed using a qualitative content analysis. Results: The analysis resulted in three main categories and eight subcategories. The main categories were: Technique and life, Technique and education, Technique and the professional support. The result showed that there were three different kinds of education; half day, three days and distance start, where the majority of the participants experienced that they had received the education they needed to feel safe with the treatment, but where a close follow-up visit to the diabetes nurse specialist is crucial. Conclusion: The advanced technology that is available today, increases quality of life and leads to a sense of safety and freedom but demands practical training and a close follow-up visit to the diabetes nurse to be associated with safe and person-centered care.
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SLEEP AND THERMOREGULATION: A STUDY OF THE EFFECT OF AMBIENT TEMPERATURE MANIPULATION ON MOUSE SLEEP ARCHITECTUREAjwad, Asma'a A. 01 January 2018 (has links)
Good quality sleep is essential for mental and physical health. Inadequate sleep impacts memory consolidation, learning and cognition, immune function, autonomic regulation, physical performance, and other vital functions. In many neurological disorders that are associated with sleep problems such as epilepsy and Alzheimer’s disease, changes in brain circuitry affect sleep-wake regulation mechanisms; this is reflected in anomalous sleep-wake architecture and usually accompanied by poor sleep depth. Thus, over many years, many approaches have been tried in humans and animal models with the goal of improving sleep quality. Unfortunately, each of those approaches comes with limitations or side effects. Thus, there is a need for a natural, safe, and low cost approach that overcomes many limitations to improve sleep and eventually the lives of individuals with sleep problems.
Environmental temperature is one of the most important factors that affect sleep in humans and other animals. Studies have shown that the part of the brain governing thermoregulation is also involved in sleep-wake regulation. Even a mild change in environmental temperature can produce a significant effect on sleep. Thus, a better understanding of the sleep-thermoregulation interaction could lead to novel ways for treating many sleep disorders. As a first step on the translational pathway, experiments in animal models of disease conditions with disordered sleep are needed for investigating sleep–thermoregulation interactions and for devising and validating related approaches to enhance sleep quality before conducting them on humans.
This dissertation explores and assesses the effect of changes in ambient temperature on sleep-wake architecture in control mice and epileptic mice, the latter from a model of temporal lobe epilepsy as an example of a disease model with disordered sleep. Then, based on the results of temperature effects on sleep in control and epileptic mice, different strategies are proposed and tested to modulate sleep through ambient temperature regulation in closed loop to improve sleep depth and regulate the timing of the sleep-wake cycle.
The results presented in this dissertation demonstrate the feasibility of sleep enhancement and regulation of its timing and duration through manipulation of ambient temperature using closed-loop control systems. Similar approaches could foreseeably be used as more natural means for enhancing deep sleep in patients with epilepsy, Alzheimer’s, or Parkinson’s disease in which poor sleep is common and associated with adverse outcomes.
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Open and closed loop model identification and validationGuidi, Figuroa Hernan 03 July 2009 (has links)
Closed-loop system identification and validation are important components in dynamic system modelling. In this dissertation, a comprehensive literature survey is compiled on system identification with a specific focus on closed-loop system identification and issues of identification experiment design and model validation. This is followed by simulated experiments on known linear and non-linear systems and experiments on a pilot scale distillation column. The aim of these experiments is to study several sensitivities between identification experiment variables and the consequent accuracy of identified models and discrimination capacity of validation sets given open and closed-loop conditions. The identified model structure was limited to an ARX structure and the parameter estimation method to the prediction error method. The identification and validation experiments provided the following findings regarding the effects of different feedback conditions: <ul> <li>Models obtained from open-loop experiments produced the most accurate responses when approximating the linear system. When approximating the non-linear system, models obtained from closed-loop experiments were found to produce the most accurate responses.</li> <li>Validation sets obtained from open-loop experiments were found to be most effective in discriminating between models approximating the linear system while the same may be said of validation sets obtained from closed-loop experiments for the nonlinear system.</li> </ul> These finding were mostly attributed to the condition that open-loop experiments produce more informative data than closed-loop experiments given no constraints are imposed on system outputs. In the case that system output constraints are imposed, closed-loop experiments produce the more informative data of the two. In identifying the non-linear system and the distillation column it was established that defining a clear output range, and consequently a region of dynamics to be identified, is very important when identifying linear approximations of non-linear systems. Thus, since closed-loop experiments produce more informative data given output constraints, the closed-loop experiments were more effective on the non-liner systems. Assessment into other identification experiment variables revealed the following: <ul> <li>Pseudo-random binary signals were the most persistently exciting signals as they were most consistent in producing models with accurate responses.</li> <li>Dither signals with frequency characteristics based on the system’s dominant dynamics produced models with more accurate responses.</li> <li>Setpoint changes were found to be very important in maximising the generation of informative data for closed-loop experiments</li></ul> Studying the literature surveyed and the results obtained from the identification and validation experiments it is recommended that, when identifying linear models approximating a linear system and validating such models, open-loop experiments should be used to produce data for identification and cross-validation. When identifying linear approximations of a non-linear system, defining a clear output range and region of dynamics is essential and should be coupled with closed-loop experiments to generate data for identification and cross-validation. / Dissertation (MEng)--University of Pretoria, 2009. / Chemical Engineering / unrestricted
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Canonical forms for linear descriptor systems with variable coefficientsRath, W. 30 October 1998 (has links)
We study linear descriptor systems with rectangular variable coefficient matrices.
Using local and global equivalence transformations we introduce normal and
condensed forms and get sets of characteristic quantities. These quantities allow us to
decide whether a linear descriptor system with variable coefficients is regularizable
by derivative and/or proportional state feedback or not. Regularizable by feedback
means for us that their exist a feedback which makes the closed loop system uniquely
solvable for every consistent initial vector.
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A.D.D : Autonomous Drink Dispenser / A.D.D : Autonom dryckesfördelareSjöberg, Mikael, Xu, Jonas January 2019 (has links)
The purpose of this report was to evaluate the feasibility of an autonomous drink dispenser where it can complement the waitstaff in their many duties. The prototype can accurately dispense a wide variety of drinks without the intervention of a human operator. The focus of the project was to pour a wide variety of drinks as accurately as possible. This can be achieved without the need for trained staff through automation. Many different components were required in order to make the prototype as consistent and safe as possible. It was discovered that so many components negatively affected the end result. The final prototype can dispense liquids from six different sources. Numerous different tests were done with the maximum deviation from the expected volume being 7.7%. This was a vast improvement on the standard deviation in alcohol content in drinks, which is 42%. The prototype can dispense up to 116 drinks per hour. / Syftet med denna rapport var att utvärdera genomförbarheten av en autonom dryckesautomat där den kunde komplettera servitören i sina många uppgifter. Prototypen kan med hög noggrannhet hälla upp en stor variation av drycker utan behovet av en mänsklig operatör. Projektets fokus var att kunna hälla ett stort antal drycker med så hög precision som möjligt. Genom automatisering kan detta uppnås utan behov av utbildad personal. Många olika slags komponenter krävdes för att göra prototypen så konsekvent och säker som möjligt. Det visade sig att denna variation skapade problem och hade en negativ effekt på det önskade slutresultatet. Den slutliga prototypen kan hälla upp vätskor från sex olika källor. Många tester gjordes med en maximal avvikelse från den förväntade volymen på 7.7%. Detta var en stor förbättring på standardavvikelsen i alkoholhaltiga drycker, vilket är 42%. Prototypen kan hälla upp till 116 drycker per timme.
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Développement d’un système d’administration de l’anesthésie en boucle ferméeCharabati, Samer 03 1900 (has links)
En salle d’opération, les tâches de l’anesthésiste sont nombreuses. Alors que l’utilisation de nouveaux outils technologiques l’informe plus fidèlement sur ce qui se passe pour son patient, ces outils font que ses tâches deviennent plus exigeantes. En vue de diminuer cette charge de travail, nous avons considérer l’administration automatique d’agents anesthésiques en se servant de contrôle en boucle fermée.
À cette fin, nous avons développé un système d’administration d’un agent anesthésique (le propofol) visant à maintenir à un niveau optimal la perte de conscience du patient pendant toute la durée d’une chirurgie. Le système comprend un ordinateur, un moniteur d’anesthésie et une pompe de perfusion. L’ordinateur est doté d’un algorithme de contrôle qui, à partir d’un indice (Bispectral IndexTM ou BIS) fournit par le moniteur d’anesthésie détermine le taux d’infusion de l’agent anesthésiant. Au départ, l’anesthésiste choisit une valeur cible pour la variable de contrôle BIS et l’algorithme, basé sur système expert, calcule les doses de perfusion de propofol de sorte que la valeur mesurée de BIS se rapproche le plus possible de la valeur cible établie.
Comme interface-utilisateur pour un nouveau moniteur d’anesthésie, quatre sortes d’affichage ont été considérés: purement numérique, purement graphique, un mélange entre graphique et numérique et un affichage graphique intégré (soit bidimensionnel). À partir de 20 scenarios différents où des paramètres normaux et anormaux en anesthésie étaient présentés à des anesthésistes et des résidents, l’étude des temps de réaction, de l’exactitude des réponses et de la convivialité (évaluée par le NASA-TLX) a montré qu’un affichage qui combine des éléments graphiques et numériques était le meilleur choix comme interface du système.
Une étude clinique a été réalisée pour comparer le comportement du système d’administration de propofol en boucle fermée comparativement à une anesthésie contrôlée de façon manuelle et conventionnelle où le BIS était aussi utilisé. Suite à l’approbation du comité d’éthique et le consentement de personnes ayant à subir des chirurgies générales et orthopédiques, 40 patients ont été distribués également et aléatoirement soit dans le Groupe contrôle, soit dans le Groupe boucle fermée. Après l’induction manuelle de propofol (1.5 mg/kg), le contrôle en boucle fermée a été déclenché pour maintenir l’anesthésie à une cible de BIS fixée à 45. Dans l’autre groupe, le propofol a été administré à l’aide d’une pompe de perfusion et l’anesthésiste avait aussi à garder manuellement l’indice BIS le plus proche possible de 45. En fonction du BIS mesuré, la performance du contrôle exercé a été définie comme excellente pendant les moments où la valeur du BIS mesurée se situait à ±10% de la valeur cible, bonne si comprise de ±10% à ±20%, faible si comprise de ±20% à ±30% ou inadéquate lorsque >±30%.
Dans le Groupe boucle fermée, le système a montré un contrôle excellent durant 55% du temps total de l’intervention, un bon contrôle durant 29% du temps et faible que pendant 9% du temps. Le temps depuis l’arrêt de la perfusion jusqu’à l’extubation est de 9 ± 3.7 min. Dans le Groupe contrôle, un contrôle excellent, bon, et faible a été enregistré durant 33%, 33% et 15% du temps respectivement et les doses ont été changées manuellement par l’anesthésiste en moyenne 9.5±4 fois par h. L’extubation a été accomplie après 11.9 ± 3.3 min de l’arrêt de la perfusion. Dans le Groupe boucle fermée, un contrôle excellent a été obtenu plus longtemps au cours des interventions (P<0.0001) et un contrôle inadéquat moins longtemps (P=0.001) que dans le Groupe contrôle.
Le système en boucle fermée d’administration de propofol permet donc de maintenir plus facilement l’anesthésie au voisinage d’une cible choisie que l’administration manuelle. / In the operating room, the anaesthetist performs numerous tasks. New technological tools better inform him about the state of the patient but render his task more demanding. To alleviate the anaesthetist workload, we have considered the automatic administration of anesthetic drugs using closed-loop control.
In this respect, we have developed a system for the administration of an anesthetic agent (propofol) in order to maintain loss of consciousness at an optimal level throughout a surgery. The system comprises a computer, an anaesthesia monitor and an infusion pump. A control algorithm installed on the computer determines the infusion rate of the hypnotic drug based on the Bispectral IndexTM (BIS) provided by the monitor. At first, the anaesthetist chooses a target value for the control variable BIS and the algorithm, which consists of an expert system, calculates the infusion doses of propofol in order to steer the measured BIS value closer to the target value.
For the user-interface of a novel anaesthesia monitor, four display types were considered: purely numeric, purely graphical, a mixed graphical and numerical and a bi-dimensional integrated graphical display. Based on 20 different scenarios where normal and abnormal anaesthesia parameters were presented to anaesthetists and residents, the study of the reaction time, response accuracy and user-friendliness (assessed by the NASA-TLX) showed that a mixed graphical and numerical display is the best preferred for the interface of the system.
A clinical study was conducted in order to compare the behaviour of the system of administering propofol in closed-loop to manually controlled anaesthesia guided by BIS. After Institutional Review Board approval and written consent, 40 patients undergoing orthopaedic or general surgery were randomly assigned to 2 groups of equal size. After manual propofol induction (1.5 mg/kg), closed loop control was used to maintain anesthesia at a target BIS of 45 (Closed-loop group); in the other group, propofol was administered manually using a syringe pump by an experienced anaesthesiologist in order to maintain a target BIS of 45 as closely as possible (Control group). The performance of the system was defined as excellent, good, poor or inadequate, when the BIS was within 10%, between 10 and 20%, between 20 and 30% or outside 30% of the target BIS, respectively.
In the Closed-loop group, the system showed excellent control during 55% of the total anaesthesia time, good control during 29% of the time and poor control during 9% of the time. The time from the end of infusion to extubation was 9 ± 3.7 min. In the Control group, excellent, good and poor control were noted during 33%, 33% and 15% of the time, respectively and doses were changed 9.5 ± 4 times per h. Extubation was achieved after 11.9 ± 3.3 min from the end of infusion. In the Closed-loop group, excellent control of anesthesia occurred significantly more often (P<0.0001) and inadequate control less often than in the Control group (P=0.001).
The present system of administering propofol in closed-loop maintains the anesthesia level closer to a given target than manual administration.
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PROPOSTA DE METODOLOGIA RECURSIVA-ITERATIVA PARA IDENTIFICAÇÃO FUZZY DE SISTEMAS NÃO LINEARES ESTOCÁSTICOS EM MALHA FECHADA / PROPOSAL OF RECURSIVE-ITERATIVE METHODOLOGY FUZZY IDENTIFICATION OF SYSTEMS STOCHASTIC LINEAR CLOSED LOOPVELOZO, Hugo Alves 20 February 2017 (has links)
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Previous issue date: 2017-02-20 / CAPES / Most methods of identifcation of closed-loop dynamic systems are developed for linear
and deterministic systems. However, most closed loop systems are nonlinear dynamic systems. In addition, such systems are subject to stochastic perturbations. Considering this
problem, this work presents a methodology for the identifcation of closed loop stochastic
nonlinear systems. For this purpose, the proposed methodology uses a local approach to
identify nonlinear dynamic systems, that is, a set of Box-Jenkins local models are used
to identify the dynamics of the nonlinear system. In this work, the nonlinear system is
modeled through a Takagi-Sugeno fuzzy inference system, where the parameters of the
antecedent of the fuzzy rules are estimated with the fuzzy clustering algorithm GustafsonKessel and the consequent Box-Jenkins model parameters are estimated with the fuzzy
fuzzy RIV (Refned Instrumental Variable) and fuzzy IVARMA (Instrumental Variable
ARMA) algorithms. The proposed method is applied in the identifcation of a closed-loop
nonlinear thermal plant. / A maioria dos métodos de identifcação de sistemas dinâmicos em malha fechada são
desenvolvidos para sistemas lineares e determinísticos. Entretanto, a maioria dos sistemas operando em malha fechada são sistemas dinâmicos não lineares. Além disso, esses
sistemas estão sujeitos a perturbações de natureza estocástica. Considerando essa problemática, este trabalho apresenta uma metodologia para identifcação de sistemas não
lineares estocásticos em malha fechada. Para isso, a metodologia proposta utiliza uma
abordagem local de identifcação de sistemas dinâmicos não lineares, ou seja, um conjunto de modelos locais Box-Jenkins são utilizados para identifcar a dinâmica do sistema
não linear. Neste trabalho, o sistema não linear é modelado por meio de um sistema de
inferência fuzzy Takagi-Sugeno, onde os parâmetros do antecedente das regras fuzzy são
estimados com o algoritmo de agrupamento fuzzy Gustafson-Kessel e o parâmetros do
modelo Box-Jenkins do consequente são estimados com os algoritmos RIV (Refned Instrumental Variable) fuzzy e IVARMA (Instrumental Variable ARMA) fuzzy. O método
proposto é aplicado na identifcação de uma planta térmica não linear em malha fechada.
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Circuits intégrés d’enregistrement et d’analyse en temps réel des potentiels de champ neuronaux : application au traitement de la maladie de Parkinson, par contrôle adaptatif de stimulations cérébrales profondes / Real time integrated circuits for recording and analyzing local field potentials : application to deep brain stimulation strategies for Parkinson’s diseaseZbrzeski, Adeline 14 October 2011 (has links)
La maladie de Parkinson est la seconde maladie neuro-dégénérative la plus fréquente à travers le monde. Dans ce contexte, le projet de recherche associé à cette thèse vise à améliorer le traitement symptomatique de la maladie de Parkinson, par le développement de procédés de stimulation cérébrale profonde adaptative. Le travail de cette thèse repose sur la conception d’un ASIC d’enregistrement et de traitement de signaux neuronaux, répondant à divers enjeux :un traitement continu et en temps réel focalisé sur des bandes spécifiques très basses-fréquences et largement configurables. L’objectif est d’utiliser l’information traitée pour le contrôle et la génération d’un signal de stimulation. Cet ASIC a été développé, caractérisé électroniquement et utilisé dans un contexte in vivo. Un système en boucle fermée a été réalisé à partir de cet ASIC, se montrant fonctionnel. Ces validations expérimentales in vivo ouvrent de nombreuses possibilités d’investigation du concept de stimulation cérébrale en boucle fermée. / Parkinson’s disease is the second most common neurodegenerative diseases throughout theworld. In this context, the research project associated with this thesis is to improve the symptomatictreatment of Parkinson’s disease through the development process of deep brain stimulationadaptive. The work of this thesis is based on the design of an ASIC for recording andprocessing of neural signals, in response to a variety of issues : ongoing treatment and real-timefocus on specific bands of very low-frequency and highly configurable. The goal is to use theprocessed information to the control and generation of a stimulation signal. This ASIC wasdeveloped, characterized and used electronically in a context in vivo. A closed-loop system wasmade from the ASIC, showing functional. These in vivo validations open up many possibilitiesfor investigation of the concept of closed-loop brain stimulation.
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Développement d’un système d’administration de l’anesthésie en boucle ferméeCharabati, Samer 03 1900 (has links)
En salle d’opération, les tâches de l’anesthésiste sont nombreuses. Alors que l’utilisation de nouveaux outils technologiques l’informe plus fidèlement sur ce qui se passe pour son patient, ces outils font que ses tâches deviennent plus exigeantes. En vue de diminuer cette charge de travail, nous avons considérer l’administration automatique d’agents anesthésiques en se servant de contrôle en boucle fermée.
À cette fin, nous avons développé un système d’administration d’un agent anesthésique (le propofol) visant à maintenir à un niveau optimal la perte de conscience du patient pendant toute la durée d’une chirurgie. Le système comprend un ordinateur, un moniteur d’anesthésie et une pompe de perfusion. L’ordinateur est doté d’un algorithme de contrôle qui, à partir d’un indice (Bispectral IndexTM ou BIS) fournit par le moniteur d’anesthésie détermine le taux d’infusion de l’agent anesthésiant. Au départ, l’anesthésiste choisit une valeur cible pour la variable de contrôle BIS et l’algorithme, basé sur système expert, calcule les doses de perfusion de propofol de sorte que la valeur mesurée de BIS se rapproche le plus possible de la valeur cible établie.
Comme interface-utilisateur pour un nouveau moniteur d’anesthésie, quatre sortes d’affichage ont été considérés: purement numérique, purement graphique, un mélange entre graphique et numérique et un affichage graphique intégré (soit bidimensionnel). À partir de 20 scenarios différents où des paramètres normaux et anormaux en anesthésie étaient présentés à des anesthésistes et des résidents, l’étude des temps de réaction, de l’exactitude des réponses et de la convivialité (évaluée par le NASA-TLX) a montré qu’un affichage qui combine des éléments graphiques et numériques était le meilleur choix comme interface du système.
Une étude clinique a été réalisée pour comparer le comportement du système d’administration de propofol en boucle fermée comparativement à une anesthésie contrôlée de façon manuelle et conventionnelle où le BIS était aussi utilisé. Suite à l’approbation du comité d’éthique et le consentement de personnes ayant à subir des chirurgies générales et orthopédiques, 40 patients ont été distribués également et aléatoirement soit dans le Groupe contrôle, soit dans le Groupe boucle fermée. Après l’induction manuelle de propofol (1.5 mg/kg), le contrôle en boucle fermée a été déclenché pour maintenir l’anesthésie à une cible de BIS fixée à 45. Dans l’autre groupe, le propofol a été administré à l’aide d’une pompe de perfusion et l’anesthésiste avait aussi à garder manuellement l’indice BIS le plus proche possible de 45. En fonction du BIS mesuré, la performance du contrôle exercé a été définie comme excellente pendant les moments où la valeur du BIS mesurée se situait à ±10% de la valeur cible, bonne si comprise de ±10% à ±20%, faible si comprise de ±20% à ±30% ou inadéquate lorsque >±30%.
Dans le Groupe boucle fermée, le système a montré un contrôle excellent durant 55% du temps total de l’intervention, un bon contrôle durant 29% du temps et faible que pendant 9% du temps. Le temps depuis l’arrêt de la perfusion jusqu’à l’extubation est de 9 ± 3.7 min. Dans le Groupe contrôle, un contrôle excellent, bon, et faible a été enregistré durant 33%, 33% et 15% du temps respectivement et les doses ont été changées manuellement par l’anesthésiste en moyenne 9.5±4 fois par h. L’extubation a été accomplie après 11.9 ± 3.3 min de l’arrêt de la perfusion. Dans le Groupe boucle fermée, un contrôle excellent a été obtenu plus longtemps au cours des interventions (P<0.0001) et un contrôle inadéquat moins longtemps (P=0.001) que dans le Groupe contrôle.
Le système en boucle fermée d’administration de propofol permet donc de maintenir plus facilement l’anesthésie au voisinage d’une cible choisie que l’administration manuelle. / In the operating room, the anaesthetist performs numerous tasks. New technological tools better inform him about the state of the patient but render his task more demanding. To alleviate the anaesthetist workload, we have considered the automatic administration of anesthetic drugs using closed-loop control.
In this respect, we have developed a system for the administration of an anesthetic agent (propofol) in order to maintain loss of consciousness at an optimal level throughout a surgery. The system comprises a computer, an anaesthesia monitor and an infusion pump. A control algorithm installed on the computer determines the infusion rate of the hypnotic drug based on the Bispectral IndexTM (BIS) provided by the monitor. At first, the anaesthetist chooses a target value for the control variable BIS and the algorithm, which consists of an expert system, calculates the infusion doses of propofol in order to steer the measured BIS value closer to the target value.
For the user-interface of a novel anaesthesia monitor, four display types were considered: purely numeric, purely graphical, a mixed graphical and numerical and a bi-dimensional integrated graphical display. Based on 20 different scenarios where normal and abnormal anaesthesia parameters were presented to anaesthetists and residents, the study of the reaction time, response accuracy and user-friendliness (assessed by the NASA-TLX) showed that a mixed graphical and numerical display is the best preferred for the interface of the system.
A clinical study was conducted in order to compare the behaviour of the system of administering propofol in closed-loop to manually controlled anaesthesia guided by BIS. After Institutional Review Board approval and written consent, 40 patients undergoing orthopaedic or general surgery were randomly assigned to 2 groups of equal size. After manual propofol induction (1.5 mg/kg), closed loop control was used to maintain anesthesia at a target BIS of 45 (Closed-loop group); in the other group, propofol was administered manually using a syringe pump by an experienced anaesthesiologist in order to maintain a target BIS of 45 as closely as possible (Control group). The performance of the system was defined as excellent, good, poor or inadequate, when the BIS was within 10%, between 10 and 20%, between 20 and 30% or outside 30% of the target BIS, respectively.
In the Closed-loop group, the system showed excellent control during 55% of the total anaesthesia time, good control during 29% of the time and poor control during 9% of the time. The time from the end of infusion to extubation was 9 ± 3.7 min. In the Control group, excellent, good and poor control were noted during 33%, 33% and 15% of the time, respectively and doses were changed 9.5 ± 4 times per h. Extubation was achieved after 11.9 ± 3.3 min from the end of infusion. In the Closed-loop group, excellent control of anesthesia occurred significantly more often (P<0.0001) and inadequate control less often than in the Control group (P=0.001).
The present system of administering propofol in closed-loop maintains the anesthesia level closer to a given target than manual administration.
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