Abstract
Fluid therapy is extensively used to treat traumatized patients as well as patients during surgery. The fluid therapy process is complex due to interpatient variability in response to therapy as well as other complicating factors such as comorbidities and general anesthesia. These complexities can result in under- or over-resuscitation. Given the complexity of the fluid management process as well as the increased capabilities in hemodynamic monitoring, closed-loop fluid management can reduce the workload of the overworked clinician while ensuring specific constraints on hemodynamic endpoints are met with higher accuracy. The goal of this paper is to provide an overview of closed-loop control systems for fluid management and highlight several key steps in transitioning such a technology from bench to the bedside.
Highlights
Fluid therapy is used extensively to treat traumatized patients as well as patients during surgery [1, 2]
Closed-loop control technologies have been used in various industries for many years, it is not until recently that active control technology has transitioned into medical applications with the majority of applications focusing on pre-clinical or research settings
The control system design process needs to employ rigorous control engineering frameworks to address important issues such as system performance, stability, and robustness to modeling uncertainly as well as disturbances
Summary
Fluid therapy is used extensively to treat traumatized patients as well as patients during surgery [1, 2]. Fluid therapy is a challenging process involving the consideration of interpatient and intrapatient variability in response to therapy as well as other factors such as comorbidities and general anesthesia. These complexities can result in under- or over-resuscitation [3,4,5]. One industry that has witnessed a wide adoption of active (i.e., closed-loop) control technologies is the aerospace industry, where closed-loop control technologies (the autopilot) have been used in various aircrafts over the past several decades. Closed-loop control technologies have been used in various industries for many years, it is not until recently that active control technology has transitioned into medical applications with the majority of applications focusing on pre-clinical or research settings
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