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Published in: Journal of Clinical Monitoring and Computing 1/2018

01-02-2018 | Editorial

The future of intraoperative blood pressure management

Authors: Frederic Michard, Ngai Liu, Andrea Kurz

Published in: Journal of Clinical Monitoring and Computing | Issue 1/2018

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Excerpt

In this issue of the Journal, Rinehart et al. [1] described a new closed loop system designed to maintain blood pressure (BP) within a predetermined target zone by triggering the automatic administration of a vasopressor. This was a computer or “in silico” study where the goal was to maintain the virtual mean arterial pressure of virtual patients between 65 and 75 mmHg. In this well controlled experimental setting, the controller performance was excellent. This study was a first development step, or engineering requirement. Animal and human studies are now needed to investigate the safety and reliability of the system in real physiologic or pathophysiologic conditions, and in an environment where artifacts and measurement errors may occur. Other groups have already conducted in vivo evaluations of closed loop systems for BP control either with fluids or vasopressors [2, 3 ]. In 222 women having spinal anesthesia for caesarean delivery, Ngan Kee et al. [3] reported a better BP control, with fewer interventions and less wobble, with computer-controlled than with manual-controlled phenylephrine infusion. Given the exponential development of computer capabilities and digital health solutions, closed loop hemodynamic systems may become available soon in operating rooms and intensive care units [4, 5]. …
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Metadata
Title
The future of intraoperative blood pressure management
Authors
Frederic Michard
Ngai Liu
Andrea Kurz
Publication date
01-02-2018
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 1/2018
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-017-9989-y

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