Descripción del proyecto
Anestesia controlada por ordenador
La administración de fármacos durante la anestesia quirúrgica la realiza de forma manual el anestesista, que tiene en cuenta parámetros fisiológicos muy específicos y la respuesta esperada del paciente a los estímulos quirúrgicos. Sin embargo, en situaciones complejas en las que hay comorbilidades del paciente o antagonismo de medicamentos, parece imposible optimizar la velocidad de infusión del fármaco. El objetivo principal del proyecto AMICAS, financiado por el Consejo Europeo de Investigación, es allanar el camino hacia la optimización de la medicación asistida por ordenador mediante modelos con múltiples variables. La idea es combinar estos modelos con la experiencia humana para reducir al máximo las grandes incertidumbres relativas a la respuesta de los pacientes anestesiados y mejorar los resultados quirúrgicos.
Objetivo
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.
Ámbito científico
- 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
Palabras clave
Programa(s)
- HORIZON.1.1 - European Research Council (ERC) Main Programme
Régimen de financiación
HORIZON-ERC - HORIZON ERC GrantsInstitución de acogida
9000 Gent
Bélgica