Under ACTAN project the main defined objective was to develop an event-based model predictive control framework for the anesthesia process. For this, the automated anesthesia process was addressed as a whole, while considering each of the subsystems involved and their specific requirements and limitations. A correct understanding of the anesthesia process requires a multidisciplinary approach incorporating various scientific disciplines, thus providing a common framework to achieve the desired goals and to ascertain any possible limitations.
In the executed research, special emphasis was placed on the depth of hypnosis and analgesia - the most important factors in the anesthesia procedure. The control system for the depth of hypnosis uses propofol administration as the control variable and the BIS index as the controlled variable. For this, several control system configurations were developed including Model Predictive Control (MPC) algorithm extended with event-based approaches. The development of the control structure was performed using a nonlinear model representing the propofol effect on the BIS index. Applying such a control structure makes the use of a linear MPC algorithm possible, exploiting the constraint handling mechanism with low computational complexity. The main objective of this novel control system was the effective use of control resources (the propofol dosage), keeping performance within the desired limits. To take full advantage of automatic control in anesthesia, there is also the need for the simultaneous control of co-administrated drugs since they have the influence on the depth of hypnosis due to mutual interaction. For this, it was necessary to design a novel robust control scheme able to handle the nonlinear response profile as well as the inter- and intra-patient variations in the patient’s analgesic state to analgesic drug infusion (e.g. reminfetanil). In this way, the developed advanced control approaches provide an efficient tool for automated anesthesia, reducing the risks of intra- and post-operative complications. It should be highlighted that the selected control system configurations were practically evaluated on real patients. The developed control algorithms were adapted and embedded on existing medical, clinical or health available infrastructures/devices/software. In the context of the project goals, the control strategies developed under ACTAN project were validated at Brescia Hospital. The practical evaluation is a big step forward in developing anesthesia process automation, demonstrating its feasibility especially in the context of model predictive control approaches.
Another goal of the MSCA Individual Fellowship is to foster the development of the individual researcher. The opportunity to manage a scientific project such as this one gave me indeed the knowledge, experience, skills, and required competency in scientific project leadership and management which will be indispensable in my future career. The ACTAN project allowed me to gain further experience in academic activities since I was involved in research initiation and coordination, and I participated in the supervision of a PhD student. These tasks provided me with additional experience in communication skills, know-how sharing and research expertise with other members of the host and collaborating institutions. Throughout the ACTAN project, I have gained research experience in the interdisciplinary collaboration thorough integration with the host research group, developed project management skills as well as learned new methodologies and techniques for organization and communication. Moreover, I have gained international experience that completes my track record, giving me an advantage in permanent position opportunities. In addition, the experience and knowledge gained in this action significantly increased my chances of attaining future funding opportunities. Considering all of these advantages, I have acquired versatile competencies allowing me to reach professional maturity. Moreover, it needs to be highlighted that outcomes from ACTAN project funded the basis for further research on MPC approach for automation in anesthesia process that undoubtedly will be continued in my future research.
