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Consumption of Cisatracurium in different age groups, using a closed loop computer controlled system.

ABSTRACT: We devised this study to quantify the effect of age on the consumption of cisatracurium under general anaesthesia, using a computer controlled closed loop infusion system. We further investigated this effect on, sufentanil and propofol consumption.74 patients of physical status I and II, requiring general anaesthesia for elective abdominal surgery, were assigned to three groups. Patients in group 1 were aged from 20 to 45, group 2 were from 46 to 64, and group 3 above 65 years old. General Anesthesia was maintained with propofol and muscle paralysis was maintained using a closed-loop computer controlled infusion of cisatracurium. For analgesia, intermittent bolus of sufentanil 10 ?g was given.Cisatracurium consumption in group 1, 2 and 3 were 1.8?±?0.3, 1.6?±?0.4 and 1.3?±?0.4 ?g/kg/min respectively. There was significant difference of cisatracurium consumption between group 1 and 3 (P?=?0.002), and the consumption of cisatracurium in group 3 was less as compared with group 2 (P?=?0.04). The average recovery index of patients in group 1, 2 and 3 were 8.8?±?2.6, 11.5?±?2.9 and 12.7?±?2.5 minutes respectively. There were difference between group 1 and 2 (P?=?0.02). As compared with group 1, the recovery index was still longer in group 3 (P?=?0.001). Patients in group 1, 2 and 3 consumed an average sufentanil 0.4?±?0.1, 0.4?±?0.1 and 0.3?±?0.1 ?g/kg/hr, respectively. There were statistical significant between group 1 and 3 (P?

SUBMITTER: Joomye S

PROVIDER: S-EPMC4021420 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Consumption of Cisatracurium in different age groups, using a closed loop computer controlled system.

Joomye Shehzaad S Yan Donglai D Wang Haiyun H Zhou Guoqiang G Wang Guolin G

BMC anesthesiology 20140421

<h4>Background</h4>We devised this study to quantify the effect of age on the consumption of cisatracurium under general anaesthesia, using a computer controlled closed loop infusion system. We further investigated this effect on, sufentanil and propofol consumption.<h4>Methods</h4>74 patients of physical status I and II, requiring general anaesthesia for elective abdominal surgery, were assigned to three groups. Patients in group 1 were aged from 20 to 45, group 2 were from 46 to 64, and group ...[more]

PMID: 24745306

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Project description:BackgroundHemodynamic resuscitation in septic shock requires aggressive fluid replacement and appropriate use of vasopressors to optimize arterial pressure (AP) and cardiac output (CO). Because responses to these drugs vary between patients and within patient over time, strict monitoring of patient condition and repetitive adjustment of drug dose are required. This task is time and labor consuming, and is associated with poor adherence to resuscitation guidelines. To overcome this issue, we developed a computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in septic shock, and evaluated the performance of the system in a canine model of endotoxin shock.MethodsOur system monitors AP, CO and central venous pressure, and computes arterial resistance (R), stressed blood volume (V) and Frank-Starling slope of left ventricle (S). The system controls R with noradrenaline (NA), and V with Ringer's acetate solution (RiA), thereby controlling AP and CO. In 4 dogs, AP and CO were measured invasively. In another 4 dogs, AP and CO were measured less invasively using clinically acceptable modalities, aiming to make the system clinically feasible. In all 8 dogs, endotoxin shock was induced by injecting Escherichia coli lipopolysaccharide, which significantly decreased AP from 95 (91-108) to 43 (39-45) mmHg, and CO from 112 (104-142) to 62 (51-73) ml·min-1·kg-1. The system was then connected to the dogs, and activated. System performance was observed over a period of 4 h.ResultsOur system immediately started infusions of NA and RiA. Within 40 min, RiA increased V to target level, and NA maintained R at target level, while S was concomitantly increased. These resulted in restoration of AP to 70 (69-71) mmHg and CO to 130 (125-138) ml·min-1·kg-1. Median of absolute performance error, an index of precision of control, was small in AP [2.5 (2.1-4.5) %] and CO [2.4 (1.4-5.5) %], which were not increased even when the variables were measured less invasively.ConclusionsIn a canine model of endotoxin shock, our system automatically improved and maintained AP and CO at their target values with small performance error. Our system is potentially an attractive clinical tool for rescuing patients with septic shock.

Project description:PurposeThe purpose of this study was to develop and test a programmable closed-loop system for tracking, modulating, and assessing dynamic iris behavior, including in the mid-dilated position.MethodsA programmable closed-loop iris control system was developed by customizing an ANTERION OCT device (Heidelberg Engineering, Heidelberg, Germany). Custom software was developed to store camera and optical coherence tomography (OCT) images, track pupillary diameter (PD), control a light-emitting diode (LED), and modulate ambient lighting to maintain the iris in a dilated, constricted, or mid-dilated position in real-time. Study participants underwent 3 consecutive 65-second scan sessions. Dynamic iris behavior in the form of peak constriction velocity (PCV) and mid-dilated iris activity (MDIA) were calculated and analyzed offline.ResultsAmong 58 participants, 56 (96.6%) were eligible for analysis based on achieving and maintaining mean PD within ±10% of the calculated mid-dilated PD. Mean participant age was 49.8 ± 18.9 years. Mean PCV was 3.92 ± 0.83 mm/s, and mean MDIA was 0.37 ± 0.15 mm. The mean difference between the calculated and achieved mid-dilated PD was 0.166 ± 0.192 mm. There were significant negative correlations between PCV and age (slope = -0.022, P < 0.001) and MDIA and age (slope = -0.004, P < 0.001). Success rates were lower (69.0%) but relationships between dynamic iris behavior and age were similar based on achieving and maintaining mean PD within ±5% of the calculated mid-dilated PD.ConclusionsA programmable closed-loop iris control system can modulate dynamic iris behavior and maintain the iris in a mid-dilated position. Pupillary constriction velocity and iris activity in the mid-dilated position decrease with age.Translational relevanceThis system can be applied to study dynamic disease processes involving the iris and establish novel biometric measures that could serve as risk factors for acute and chronic primary angle closure glaucoma (PACG).

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Consumption of Cisatracurium in different age groups, using a closed loop computer controlled system.

Publications

Consumption of Cisatracurium in different age groups, using a closed loop computer controlled system.

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