The effect of a model-based predictive display on the control of end-tidal sevoflurane concentrations during low-flow anesthesia.

Anesthesia and Analgesia
R Ross KennedySandra Gilles

Abstract

We have shown that a multicompartment model accurately predicts end-tidal (ET) sevoflurane (sevo) and isoflurane concentrations. The model has been adapted to use real-time fresh gas flow and vaporizer settings to display a 10-min prediction of ET sevo concentrations. In this study, we evaluated the effect of the predictive display on the speed and accuracy of changes in ET sevo by the anesthesiologist. Fifteen patients were studied in whom sevo-based anesthesia was expected to last more than 2 h. Four step changes of target ET concentration (+0.5, +1.0, -1.0, and -0.5 vol%) were made either unaided or with the prediction display. Fresh gas flow was 1 L/min. Response time, maximum overshoot, and stability in the 5 min after the target was achieved were compared by using two-tailed paired Student's t-tests. Changes were made on average 1.5-2.3 times faster with the predictive display than without it. These differences were statistically significant (P < 0.05) for the +0.5, +1.0, and -0.5 vol% step changes but not for the -1.0 vol% change. There were no differences in the degree of overshoot or stability. These differences are comparable to those seen with an automatic feedback control system. This system may simplify the adminis...Continue Reading

References

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Oct 25, 2003·Anesthesiology·Talmage D Egan, Steven L Shafer

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Citations

May 29, 2007·Der Anaesthesist·S KreuerT Bouillon
May 8, 2014·Journal of Anaesthesiology, Clinical Pharmacology·Meenoti Pramod PotdarManjeet P Save
Jul 15, 2005·Best Practice & Research. Clinical Anaesthesiology·I Odin, P Feiss
Jun 9, 2006·Applied Ergonomics·Penelope Sanderson
Jan 10, 2012·Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists·J Sethu MadhavanPreethy J Mathew
May 16, 2006·Human Factors·Frank A DrewsDwayne R Westenskow
Apr 19, 2008·Anesthesia and Analgesia·R Ross Kennedy, Richard A French
Mar 14, 2019·Journal of the American Medical Informatics Association : JAMIA·Rosalie G WallerGuilherme Del Fiol
Apr 19, 2006·Anaesthesia and Intensive Care·R Kennedy
Dec 23, 2006·Anaesthesia and Intensive Care·R R Kennedy, M M Sakowska
Dec 18, 2009·Anaesthesia and Intensive Care·A B Baker
Apr 14, 2011·Anaesthesia and Intensive Care·R R Kennedy, R A French
Jun 23, 2018·Journal of Clinical Monitoring and Computing·Christopher W Connor

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