Health Tech Lunch - Alena Simalatsar

Health Tech Lunch - 24.04.2017, 12h00 - Sion, HEI (Room BR01)

Presentation by Alena Simalatsar

Title : The controlled delivery of intravenous anesthetics

The controlled delivery of intravenous anesthetics aims at fast and safe achievement and maintenance of a certain depth of hypnosis (DOH), correlated with the plasma concentration of the administered drugs (e.g. propofol, fentanyl or midazolam, etc.). Today, such drugs are regularly injected by Target Controlled Infusion (TCI) systems, piloted by quantitative predictions of plasma drug concentration based on pharmacokinetic (PK) models complemented with an algorithm, that based on the predicted output (e.g. drug concentration) adjusts the drug delivery rate in an open-loop manner. However, the inaccuracy of these models can reach up to 30-50%  due to inter- and intra patients’ variability. Several attempts have been made to improve the situation by closing the loop with electroencephalogram (EEG) monitoring, deriving the bispectral index (BIS) associated to the DOH. However, BIS only indirectly depends on drug delivery rate, is delayed with respect to the changes of drug concentration in plasma, and can be affected by various sources of noise, which can lead to overdosing or unexpected awakening of a patient. In this talk I will present our approach, in which we close the loop by continuous measurement of anesthetics in patients plasma.