The Development of a System to Guide Volatile Anaesthetic Administration

Abstract

We have developed and deployed within our operating rooms a system which provides real-time estimates of effectsite levels of inhalational anaesthetic agents along with forward predictions of end-tidal and effect-site concentrations. The initial aim of this project was to provide users of inhalational agents with tools similar to those available in target-controlled infusion systems. This paper describes the development and implementation of the system and outlines evaluation and uses of the system. The prototype was developed by combining a locally developed data logging and trend display system with a model of uptake developed as a teaching tool in 1982. This uptake model performs as well as contemporary models of propofol uptake and distribution. Following initial evaluation, the system has been deployed in over half our operating rooms and uses data gathered from the Datex/GE Anaesthesia Delivery Unit anaesthetic machines. We have conducted a number of studies of the system itself, explored aspects of the underlying models, and used the system to investigate effect-site guided anesthesia and as a tool for data collection in other studies. The system has been well accepted locally and has been shown to facilitate faster changes in inhalational levels. We have also seen a significant decrease in fresh gas flow rates over recent years and attribute this in part to the predictive system, which simplifies the task of determining the appropriate combination of gas flow and vapour dial setting. The system also provides a useful platform for a range of research projects.

A Ten-Year Audit of Fresh Gas Flows in a New Zealand Hospital: The Influence of the Introduction of Automated Agent Delivery and Comparisons with Other Hospitals

“…Our changes have occurred without specific individualised feedback. We have previously speculated 4 that our locally developed system for forward prediction of inhaled anaesthetic levels 17 , which is very similar to the 'Vapor View' display of the recently released Perseus ® machine from Dräger, helped with a cultural shift, as users became more comfortable with lower flows. We also speculate that experience with our guidance system made users receptive to the ETc mode of the Aisys ® .…”

Desempeño predictivo y clínico de un dispositivo target-controlled infusion para sevofluorano en una estación de trabajo convencional: correlación farmacocinética del modelo empleado

“…Diferentes aplicaciones se han utilizado para implementar FBGF y FMGF con vaporizador: el simulador Gasman ®9 , el software predictivo en tiempo real de las concentraciones de halogenado desarrollado por Kennedy et al 10 , y un software que alerta si el FGF supera un litro o 2 CAM-h para sevofluorano 11 . Estos 2 últimos programas lograron reducir el FGF empleado un 35% 12 y un 24%, respectivamente.…”

Data acquisition from S/5 GE Datex anesthesia monitor using VSCapture: An open source.NET/Mono tool

“…[1] Capturing these vital signs can allow for statistical analysis, development of models of anesthetic maintenance and recovery, hemodynamic-respiratory interactions. [2] Automated data capture and record-keeping accurately stores events that maybe otherwise omitted in manual data logging. [3] These data capture components maybe used to develop anaesthesia information management systems that help in quality assurance.…”