Project description
Computer-controlled anaesthesia
Administration of drugs during surgical anaesthesia occurs manually by the anesthesiologist, who takes into account very specific physiological parameters and expected patient response to surgical stimuli. In complex situations, though, involving patient comorbidities or drug antagonism, optimisation of drug infusion rate seems impossible. The key objective of the AMICAS project, funded by the European Research Council, is to pave the way towards computer-assisted drug optimisation using multivariable models. The idea is to combine these models with human expertise for reducing as much as possible the large uncertainties in patient response under anaesthesia and improving surgical outcomes.
Objective
A major challenge in anesthesia is to adapt the drug infusion rates from observed patient response to surgical stimuli. The patient models are based on nominal population characteristic response and lack specific surgical effects. In major surgery (e.g. cardiac, transplant, obese patients) modelling uncertainty stems from significant blood losses, anomalous drug diffusion, drug effect synergy/antagonism, anesthetic-hemodynamic interactions, etc. This complex optimisation problem requires superhuman abilities of the anesthesiologist.
Computer controlled anesthesia holds the answer to be the game changer for best surgery outcomes. Although few, clinical studies report that computer based anesthesia for one or two drugs outperforms manual management. In reality, clinical practice mitigates a multi-drug optimization problem while accommodating large patient model uncertainty. The anesthesiologist makes decisions based on future surgeon actions and expected patient response. This is a predictive control strategy, a mature methodology in systems and control engineering with potential to faster recovery times and lower risk of complications.
The goal of this proposal is to advance the scope and clinical use of computer based constrained optimization of multi-drug infusion rates for anesthesia with strong effects on hemodynamics. I plan to identify multivariable models and minimize the large uncertainties in patient response. With adaptation mechanisms from nominal to individual patient models, we design multivariable optimal predictive control methodologies to manage strongly coupled dynamics. To maximize performance of the closed loop, we model the surgical stimulus as a known disturbance signal and additional bolus infusions from anesthesiologist as known inputs.
I am convinced that integration of human expertise with computer optimization is a successful solution for breakthrough into clinical practice.
Fields of science
Not validated
Not validated
- engineering and technologyelectrical engineering, electronic engineering, information engineeringelectronic engineeringcontrol systems
- medical and health sciencesclinical medicinesurgery
- engineering and technologyelectrical engineering, electronic engineering, information engineeringelectronic engineeringcontrol engineering
Keywords
Programme(s)
- HORIZON.1.1 - European Research Council (ERC) Main Programme
Funding Scheme
HORIZON-ERC - HORIZON ERC GrantsHost institution
9000 Gent
Belgium