This reads a bit more like a research article than a blog post. A bit more relaxed language would help with the readability. Another suggestion would be breaking up the article more into smaller almost question and answer sections so that the reader can follow exactly what is being explained as the post goes along.
This is a higher level application that requires a bit more scientific and specific language, and could be helped further explanation as to what certain things are and why they are important on a lower level. This blog post was written very well and has all of the correct content.
Smart devices to deliver sedation are changing the landscape
It is also very intriguing and definitely has a current market. I think the proposed control scheme makes sense and the disturbance variables are clearly listed. While they were addressed by saying that an anesthesiologist would still need to be present, it would be interesting if there were any other potential ideas for controlling these disturbance variables or reacting to them. I enjoyed reading this article and feel like I learned something new and very important. I hope I have one of these machines helping my anesthesiologist if I get surgery!
This entire article was incredibly interesting to read! I was shocked by how close it seems we may be to offering robotic, physician care. Personally, I cannot help but be a little nervous to let a machine administer a drug to patients that has fatal side effects when taken in too large of a dose. Nevertheless, if the system is proven to be more precise in its administration than current techniques, then I can see this being implemented into health care in the near future. This being said, I think a little more depth into how exactly the system would work in a health care environment would be useful.
For example, are human anthologists still needed to operate the machinery or can the set point just be determined by some computer algorithm and then any individual in the hospital can set the machine to that set-point and hook it up to the patient? If the use of a trained human is still required then I think it would be interesting to ponder the usefulness of this system, economically. Right now, anesthesiologists are paid large salaries to complete their job, in part because of the many years of training it takes to master this skill. That being said, if they are still needed as more of a back-up measure if the system were to fail, would they still be paid the same or would their salary decrease.
On another note, all parts of the proposed scheme were extremely well explained. At no point did I find myself questioning any of the medical terminology used throughout the article. I also thought that all of the figures used were extremely helpful in discussing your topics and helping the reader to visualize the processes you were speaking of. This especially holds true for the BIS index in figure 2, since that is an obscure topic when you first hear about it. Again, this article was extremely well thought out and kept my attention the whole time!
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I am interested to see where this may take the world of medicine in the years to come! Nice job! First of all, I think you guys did a really good job! I believe this technology will definitely benefit patients in surgeries. The structure of this paper is well organized. It first introduces the background information of this technique and then states how it works. The proposed control scheme is well explained and reasonable. I really like figures you provided in the paper since it did help me understand those subtle and unfamiliar terms such as the BIS index. As you guys said in the paper, the controlled variables include the measurement of the heart rate, blood pressure, respiration and oxygen level in the blood.
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Because of these variables varied significantly for people with different age, gender and other factors, EEG and BIS are chosen as the alternatives. In this system, the amount of propofol injected is the manipulated variable. The potential disturbances for this system include the sudden jumps in reading of the BIS.
I think your manipulated and controlled variables are able to meet your expectation that delivery of propofol can be performed automatically and reducing the cost to the clinic as well as the workload of the anesthesiologist. To alleviate the effect brought from the disturbance, sudden jumps of the BIS, I think it is possible to add a PID controller into your loop as the PID controller is able to adjust the error will happen.
An Introduction to Robots in Anaesthesia
Reading this article does make me learn something new but I have to say it is not easy to read as I spent more time on reading and understanding the information provided in this article than I did in another one. I think the form and content of this article are more like a research paper instead of a blog.
I think it is better to separate this article into several small pieces and just introduce one piece completely. It might be helpful for people who do not have enough background information on drug delivery to read and understand. Although I do think your designs are applicable, there is one major aspect is necessary for you guys to investigate — the cost. It is necessary to compare the cost of traditional propofol delivery with the automatic one. If the cost of the automatic one is pretty high, it might not be an appropriate application in the future surgeries for patients.
In addition, in the article, with the help of this new system, an anesthesiologist would still need to be present. As a result, this automatic drug delivery system does not totally replace the role as the anesthesiologist does. In this way, it is hard to decrease the clinic cost and make people willing to adopt this technique. I really enjoy reading this article and believe with the progress of biomolecular engineering, this automated closed-loop controlled propofol delivery system will definitely be the reality. The idea behind this closed-loop propofol delivery system and its potential implications on the health care system are truly amazing.
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Despite being a very complex topic, I think the functionality of this propofol delivery system was explained well given the target audience. The schematic highlighting the feedback loop that would be implemented in this control scheme was a nice touch to enhance the clarity of the system. From this schematic, it can be gleaned that propofol injections will be manipulated based upon BIS measurements.
Although I do have some background in biochemistry and human anatomy, I think that the information contained in this article is accessible to the average reader. I think the proposed controlled scheme would be very effective in controlling BIS in patients undergoing surgery. Potential disturbance variables that would cause a sudden jump in the BIS value were also appropriately addressed. Although not considered in the controller synthesis, they highlight the need for a technician during all procedures. Hospitals are well equipped with various back-up energy sources but unexpected malfunctions happen.
As sad as it may be, the American health care system, like any other profitable business, is obsessed with money. Anesthesia drugs, like propofol, and anesthesiologists are expensive.
Automation of anaesthesia: a review on multivariable control.
Therefore, I think the health care system will quickly utilize this closed-loop propofol delivery system since this control scheme allows for a more precise amount of propofol to be administered, eliminating the waste of expensive drugs. I am not sure if the general public will be as excited about an automated anesthetic machine, however. Surgeries are often surrounded by clouds of intense emotions as the patient and their close friends and family attempt to do anything possible to increase the health of the individual.
With this in mind, it is very understandable to see why some people may be skeptical of allowing the consciousness of their loved one be dictated by a machine. When you think about it, however, some of the most effective medical advances were initially received with skepticism. For example, I recently read an article about the invention of incubators. Despite the fact they are now used ubiquitously in hospitals for newborn babies, the public was originally not very accepting of this technology.
Only time and consistent results can sway public opinion on such a topic. It was very exciting to learn about this new medical advancement. Welcome to the future, everyone. This article is very informative about how anesthesia works and how to measure if the patients are completely under or they still have conciseness with the anesthesia. It is also a very interesting idea since that deliver propofol automative instead of manually since that manual injection might not be as accurate and efficient as automative because there can be a lot more errors happen to the patient when it is manual injection than automative because machine can be more precise than human can be.
Therefore, this application makes sense that it wants to make the propofol injection system automative so reduce error, since anesthesia process is a very delicate process. The control scheme is pretty clear and makes sense. The manipulated variable is the amount of propofol injected and the control variable is the state of conciseness of the patient, and the state of conciseness is being measured by BIS value, which can be deduced by the four different measurements you guys mentioned above.
For the disturbance variable, I think that since the control loop is measuring the BIS values, so the sudden jump of BIS values from the patient might cause danger since the control system might accidentally inject more propofol into the system when it is not needed. Overall, I think it is a good idea to have an automative, controlled propofol delivery system since it can mean a safer way to deliver anesthesia than by a doctor because human generally makes more errors than the machine, and an over or under dose of the propofol will result in the discomfort of the patient either during or after the operation.
So a closely measure and controlled anesthesia deliver system would be a very helpful thing to have. The problem about the automative systems is that the set point can be changed by someone either intentionally or unintentionally, which can cause various issues.
So even though it is automative system, the doctor should check on the system before and during the operation. But the time will ease the problem just like what happen during the industry revolution when machine starts to do the work of man. Your email address will not be published. Our research will focus on the deployment of new sensors optimized for controlled drug delivery, robust control methodology and extensive clinical validation. Clinical partner in the project is the Department of Anesthesia at the British Columbia Children's Hospital BCCH , Vancouver, Canada, where patient modeling data is collected and clinical trials of the control system are conducted.
Our current aim is to extend the system to control hypnosis and analgesia simultaneously, by adding a second drug. Klaske van Heusden, Guy A. Dumont, Kristian Soltesz, Christian L. Mark Ansermino: " Design and clinical evaluation of robust PID control of propofol anesthesia in children ". Dumont, J. Mark Ansermino: " Individualized closed-loop control of propofol anesthesia: A preliminary study ".
Biomedical Signal Processing and Control, 8: 6, pp. Kristian Soltesz: On Automation in Anesthesia. Nicholas West, Guy A. Mark Ansermino: " Robust closed-loop control of induction and maintenance of propofol anesthesia in children ".
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