Nonlinear dynamics of the patient’s response to drug effect during general anesthesia

In today’s healthcare paradigm, optimal sedation during anesthesia plays an important role both in patient welfare and in the socio-economic context. For the closed-loop control of general anesthesia, two drugs have proven to have stable, rapid onset times: propofol and remifentanil. These drugs are related to their effect in the bispectral index, a measure of EEG signal. In this paper wavelet time–frequency analysis is used to extract useful information from the clinical signals, since they are time-varying and mark important changes in patient’s response to drug dose. Model based predictive control algorithms are employed to regulate the depth of sedation by manipulating these two drugs. The results of identification from real data and the simulation of the closed loop control performance suggest that the proposed approach can bring an improvement of 9% in overall robustness and may be suitable for clinical practice.

Développement d’un système d’administration de l’anesthésie en boucle fermée

En salle d’opération, les tâches de l’anesthésiste sont nombreuses. Alors que l’utilisation de nouveaux outils technologiques l’informe plus fidèlement sur ce qui se passe pour son patient, ces outils font que ses tâches deviennent plus exigeantes. En vue de diminuer cette charge de travail, nous avons considérer l’administration automatique d’agents anesthésiques en se servant de contrôle en boucle fermée. À cette fin, nous avons développé un système d’administration d’un agent anesthésique (le propofol) visant à maintenir à un niveau optimal la perte de conscience du patient pendant toute la durée d’une chirurgie. Le système comprend un ordinateur, un moniteur d’anesthésie et une pompe de perfusion. L’ordinateur est doté d’un algorithme de contrôle qui, à partir d’un indice (Bispectral IndexTM ou BIS) fournit par le moniteur d’anesthésie détermine le taux d’infusion de l’agent anesthésiant. Au départ, l’anesthésiste choisit une valeur cible pour la variable de contrôle BIS et l’algorithme, basé sur système expert, calcule les doses de perfusion de propofol de sorte que la valeur mesurée de BIS se rapproche le plus possible de la valeur cible établie. Comme interface-utilisateur pour un nouveau moniteur d’anesthésie, quatre sortes d’affichage ont été considérés: purement numérique, purement graphique, un mélange entre graphique et numérique et un affichage graphique intégré (soit bidimensionnel). À partir de 20 scenarios différents où des paramètres normaux et anormaux en anesthésie étaient présentés à des anesthésistes et des résidents, l’étude des temps de réaction, de l’exactitude des réponses et de la convivialité (évaluée par le NASA-TLX) a montré qu’un affichage qui combine des éléments graphiques et numériques était le meilleur choix comme interface du système. Une étude clinique a été réalisée pour comparer le comportement du système d’administration de propofol en boucle fermée comparativement à une anesthésie contrôlée de façon manuelle et conventionnelle où le BIS était aussi utilisé. Suite à l’approbation du comité d’éthique et le consentement de personnes ayant à subir des chirurgies générales et orthopédiques, 40 patients ont été distribués également et aléatoirement soit dans le Groupe contrôle, soit dans le Groupe boucle fermée. Après l’induction manuelle de propofol (1.5 mg/kg), le contrôle en boucle fermée a été déclenché pour maintenir l’anesthésie à une cible de BIS fixée à 45. Dans l’autre groupe, le propofol a été administré à l’aide d’une pompe de perfusion et l’anesthésiste avait aussi à garder manuellement l’indice BIS le plus proche possible de 45. En fonction du BIS mesuré, la performance du contrôle exercé a été définie comme excellente pendant les moments où la valeur du BIS mesurée se situait à ±10% de la valeur cible, bonne si comprise de ±10% à ±20%, faible si comprise de ±20% à ±30% ou inadéquate lorsque >±30%. Dans le Groupe boucle fermée, le système a montré un contrôle excellent durant 55% du temps total de l’intervention, un bon contrôle durant 29% du temps et faible que pendant 9% du temps. Le temps depuis l’arrêt de la perfusion jusqu’à l’extubation est de 9 ± 3.7 min. Dans le Groupe contrôle, un contrôle excellent, bon, et faible a été enregistré durant 33%, 33% et 15% du temps respectivement et les doses ont été changées manuellement par l’anesthésiste en moyenne 9.5±4 fois par h. L’extubation a été accomplie après 11.9 ± 3.3 min de l’arrêt de la perfusion. Dans le Groupe boucle fermée, un contrôle excellent a été obtenu plus longtemps au cours des interventions (P<0.0001) et un contrôle inadéquat moins longtemps (P=0.001) que dans le Groupe contrôle. Le système en boucle fermée d’administration de propofol permet donc de maintenir plus facilement l’anesthésie au voisinage d’une cible choisie que l’administration manuelle.

Modos ventilatorios avanzados : Ventilación de Soporte Adaptativo (ASV)

El soporte ventilatorio es una de las intervenciones más utilizadas en las unidades de cuidado intensivo. A pesar de su rol «salvador» puede ser un procedimiento riesgoso para el paciente si no es aplicado apropiadamente. Para disminuír los riesgos inherentes a la misma, modos ventilatorios avanzados continúan siendo desarrollados a fin de mejorar los desenlaces clínicos de los pacientes. Estos avances incluyen sistemas de control de asa cerrada, como el ASV, el cual se ajusta automáticamente a los requerimientos del paciente. Es importante el entendimiento de este novedoso modo ventilatorio por el personal médico, incluyendo sus efectos en la mecánica pulmonar. Este artículo discutirá sobre el modo de ventilación de soporte adaptativo haciendo énfasis particular en sus parámetros, ventajas y desventajas sobre la oxigenación y ventilación.

Controlling a mobile robot with a biological brain

The intelligent controlling mechanism of a typical mobile robot is usually a computer system. Some recent research is ongoing in which biological neurons are being cultured and trained to act as the brain of an interactive real world robot�thereby either completely replacing, or operating in a cooperative fashion with, a computer system. Studying such hybrid systems can provide distinct insights into the operation of biological neural structures, and therefore, such research has immediate medical implications as well as enormous potential in robotics. The main aim of the research is to assess the computational and learning capacity of dissociated cultured neuronal networks. A hybrid system incorporating closed-loop control of a mobile robot by a dissociated culture of neurons has been created. The system is flexible and allows for closed-loop operation, either with hardware robot or its software simulation. The paper provides an overview of the problem area, gives an idea of the breadth of present ongoing research, establises a new system architecture and, as an example, reports on the results of conducted experiments with real-life robots.

Adaptation of an commercially available stabilised R/C helicopter to a fully autonomous surveillance UAV

This paper presents the development of an autonomous surveillance UAV that competed in the Ministry of Defence Grand Challenge 2008. In order to focus on higher-level mission control, the UAV is built upon an existing commercially available stabilised R/C helicopter platform. The hardware architecture is developed to allow for non-invasion integration with the existing stabilised platform, and to enable to the distributed processing of closed loop control and mission goals. The resulting control system proved highly successful and was capable of flying within 40knott gusts. The software and safety architectures were key to the success of the research and also hold the potential for use in the development of more complex system comprising of multiple UAVs.

Cultured neural networks

This article looks at the use of cultured neural networks as the decision-making mechanism of a control system. In this case biological neurons are grown and trained to act as an artificial intelligence engine. Such research has immediate medical implications as well as enormous potential in computing and robotics. An experimental system involving closed-loop control of a mobile robot by a culture of neurons has been successfully created and is described here. This article gives a brief overview of the problem area and ongoing research. Questions are asked as to where this will lead in the future.

A search for invariant relative satellite motion

This report presents the canonical Hamiltonian formulation of relative satellite motion. The unperturbed Hamiltonian model is shown to be equivalent to the well known Hill-Clohessy-Wilshire (HCW) linear formulation. The in°uence of perturbations of the nonlinear Gravitational potential and the oblateness of the Earth; J2 perturbations are also modelled within the Hamiltonian formulation. The modelling incorporates eccentricity of the reference orbit. The corresponding Hamiltonian vector ¯elds are computed and implemented in Simulink. A numerical method is presented aimed at locating periodic or quasi-periodic relative satellite motion. The numerical method outlined in this paper is applied to the Hamiltonian system. Although the orbits considered here are weakly unstable at best, in the case of eccentricity only, the method ¯nds exact periodic orbits. When other perturbations such as nonlinear gravitational terms are added, drift is signicantly reduced and in the case of the J2 perturbation with and without the nonlinear gravitational potential term, bounded quasi-periodic solutions are found. Advantages of using Newton's method to search for periodic or quasi-periodic relative satellite motion include simplicity of implementation, repeatability of solutions due to its non-random nature, and fast convergence. Given that the use of bounded or drifting trajectories as control references carries practical di±culties over long-term missions, Principal Component Analysis (PCA) is applied to the quasi-periodic or slowly drifting trajectories to help provide a closed reference trajectory for the implementation of closed loop control. In order to evaluate the e®ect of the quality of the model used to generate the periodic reference trajectory, a study involving closed loop control of a simulated master/follower formation was performed. 2 The results of the closed loop control study indicate that the quality of the model employed for generating the reference trajectory used for control purposes has an important in°uence on the resulting amount of fuel required to track the reference trajectory. The model used to generate LQR controller gains also has an e®ect on the e±ciency of the controller.

Stabilizing a class of time delay systems using the Hermite-Biehler theorem

In this paper we use the Hermite-Biehler theorem to establish results for the design of fixed order controllers for a class of time delay systems. We extend results of the polynomial case to quasipolynomials using the property of interlacing in high frequencies of the class of time delay systems considered. (C) 2003 Elsevier B.V. All rights reserved.

Electronic ballast for multiple fluorescent lamp systems

An electronic ballast for multiple tubular fluorescent lamp systems is presented. The proposed structure has a high value for the power factor, a dimming capability, and soft switching of the semiconductor devices operated at high frequencies. A zero-current switching pulse width modulated SEPIC converter is used as the rectifying stage and it is controlled using the instantaneous average input current technique. The inverting stage consists of classical resonant half-bridge converter with series-resonant parallel-loaded filters. The dimming control technique is based on varying the switching frequency and monitoring the phase shift of the current drained by the filters and lamps in order to establish a closed loop control. Experimental results are presented that validate the theoretical analysis.

New approach of induction machine drive using an adaptive digital PID controller with gain planning based on artificial neural networks

The present work introduces a new strategy of induction machines speed adjustment using an adaptive PID (Proportional Integral Derivative) digital controller with gain planning based on the artificial neural networks. This digital controller uses an auxiliary variable to determine the ideal induction machine operating conditions and to establish the closed loop gain of the system. The auxiliary variable value can be estimated from the information stored in a general-purpose artificial neural network based on CMAC (Cerebellar Model Articulation Controller).

Modeling of pre-regulator boost ZCS interleaved operating in critical conduction mode and with high power factor

This paper presents a new pre-regulator boost operating in the boundary area between the continuous and discontinuous conduction modes of the boost inductor current, where the switches and boost diode performing zero-current commutations during its turn-off, eliminating the disadvantages related to the reverse recovery losses and electromagnetic interference problems of the boost diode when operating in the continuous conduction mode. Additionally, the interleaving technique is applied in the power cell, providing a significant input current ripple reduction. It should be noticed that the main objective of this paper is to present a complete modeling for the converter operating in the critical conduction mode, allowing an improved design procedure for interleaved techniques with high input power factor, a complete dynamic analysis of the structure, and the possibility of implementing digital control techniques in closed loop.

Study of utilization of petrol engine equipped with exhaust gas recirculation (EGR) and catalytic converter to reduce consumption and NOx emission

Study of consumption rate and gaseous pollutant emission from engine tests simulating real work conditions, using spark point manually controlled and exhaust gas recirculation (EGR) in diverse proportion levels. The objective of this work is to re-examine the potential of the EGR conception, a well-known method of combustion control, employed together electronic fuel injection and three-way catalytic converter closed-loop control at a spark ignition engine, verifying the performance characteristics and technical availability of this conception to improve pollution control, fuel economy at low torque drive condition and to improve the engine exhaust components useful life. The pollutant emissions and consumption levels under operational conditions simulations were analysed and compared with the expected by concerning theory and real tests performed by EGR equipped engines by factory. Copyright © 2006 Society of Automotive Engineers, Inc.

Eletroestimulador funcional de oito canais com malha de realimentação utilizando Controlador Digital

Pós-graduação em Engenharia Elétrica - FEIS

Controle de movimentos de pacientes paraplégicos utilizando modelos fuzzy T-S

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Digital controller design considering hardware constraints: application in a paraplegic patient

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)