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

机译:一种医学昏迷生理闭环控制装置的设计实现与评价

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摘要

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:有关可靠性和安全性的担忧以及对构成适当性能评估的不确定性,已阻碍了PCLC设备的临床翻译。我们描述了一种通过设计,实施和评估PCLC设备以交付医学诱发的昏迷以应对这些挑战的尝试,目的是最终进行临床试验。该设备通过响应被称为猝发抑制的脑电图(EEG)模式,自动调节丙泊酚(一种全身麻醉剂)的输注速率来工作。我们还设计并实现了一种计算型患者模型,该模型可与硬件连接并响应异丙酚输注而产生逼真的EEG信号。计算患者模型用于硬件在环研究中,以评估我们PCLC设备在实际扰动下的行为。最后,我们测试了PCLC设备在啮齿动物中的性能。这些研究的结果表明,对医学上引起的昏迷进行闭环控制是可行且可靠的。因此,我们的工作产生了PCLC装置和相关的临床前证据,以支持临床试验。

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