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Management of ICU Patients’ Sedation Could Soon Become Automated

Monday February 14, 2011
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Researchers in Georgia say they are closer to developing an automated system for the management of sedation in ICUs.

The researchers, with the Georgia Institute of Technology and the Northeast Georgia Medical Center, hope to implement control algorithms that will use clinical data to accurately gauge a patient’s level of sedation and notify medical staff of any change.

The technology could ease the burden on ICU nurses, according to one of the researchers.

“ICU nurses have one of the most task-laden jobs in medicine and typically take care of multiple patients at the same time,” said James Bailey, chief medical informatics officer at the Northeast Georgia Medical Center in Gainesville, Ga., and a certified anesthesiologist and intensive care specialist.

“So if we can use control system technology to automate the task of sedation, patient safety will be enhanced and drug delivery will improve in the ICU.”

At the IEEE Conference on Decision and Control, the researchers presented an analysis of more than 15,000 clinical measurements from 366 ICU patients they classified as “agitated” or “not agitated” in terms of level of sedation. The algorithm returned the same results as the assessment by hospital staff 92% of the time.

“Manual sedation control can be tedious, imprecise, time-consuming and sometimes of poor quality, depending on the skills and judgment of the ICU nurse,” said Wassim Haddad, a professor in the Georgia Tech School of Aerospace Engineering.

“Ultimately, we envision an automated system in which the ICU nurse evaluates the ICU patient [and] enters the patient’s sedation level into a controller, which then adjusts the sedative dosing regimen to maintain sedation at the desired level by continuously collecting and analyzing quantitative clinical data on the patient.”

The project is supported by the U.S. Army and could extend the capability of the healthcare system to treat large numbers of injured soldiers.

This research builds on Haddad and Bailey’s previous work automating anesthesia in hospital ORs. Their algorithms control the infusion of an anesthetic drug agent to maintain a desired constant level of depth of anesthesia during surgery.

Clinical trial results, which will be published in the March issue of the journal IEEE Transactions on Control Systems Technology, demonstrate excellent regulation of unconsciousness, allowing for a safe and effective administration of an anesthetic agent.

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