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Design, Implementation, and Evaluation of a Physiological Closed-loop Control Device for Medically-induced Coma

机译:用于医学诱导的昏迷的生理闭环控制装置的设计,实现和评估

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Concerns regarding reliability and safety, as well as uncertainties about what constitutes adequate performance evaluation, have impeded the clinical translation of PCLC devices. We describe an attempt to address these challenges through design, implementation, and evaluation of a PCLC device for delivering medically-induced coma, with the intention to eventually conduct a clinical trial. This device works by automatically adjusting the infusion rate of propofol - a general anesthetic - in response to an electroencephalogram (EEG) pattern called burst suppression. We also designed and implemented a computational patient model which interfaces with hardware and produces realistic EEG signals in response to propofol infusion. The computational patient model is used in hardware-in-the-loop studies to evaluate the behavior of our PCLC device under realistic perturbations. Finally, we have tested the performance of our PCLC device in rodents. Results from these studies suggest that closed-loop control of medically-induced coma in humans is feasible and robust. Consequently, our work produced a PCLC device and relevant pre-clinical evidence in support of a pilot clinical trial.
机译:关于可靠性和安全性的担忧以及关于构成足够性能评估的不确定性,已经阻碍了PCLC器件的临床翻译。我们描述通过设计,实施和评估PCLC设备来解决这些挑战来提供医学诱导的昏迷的尝试,有意最终进行临床试验。该装置通过自动调节异丙酚的输液率 - 响应于爆发抑制的脑电图(EEG)模式而调整异丙酚的输液率。我们还设计并实现了一种计算患者模型,该模型与硬件接口,并响应异丙酚输注产生现实的EEG信号。计算患者模型用于循环研究中的硬件研究,以评估我们PCLC设备在现实扰动下的行为。最后,我们已经测试了我们在啮齿动物中的PCLC设备的性能。这些研究的结果表明,人类中医学诱导的彗星的闭环控制是可行和稳健的。因此,我们的工作制作了PCLC设备和相关的临床前证据,以支持试点临床试验。

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