In Silico testing of the semi-closed loop infusion system with a new simulator

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dc.contributor.author Markevicius, V.
dc.contributor.author Andrijauskas, A.
dc.contributor.author Navikas, D.
dc.contributor.author Dubauskiene, N.
dc.contributor.author Porvaneckas, N.
dc.contributor.author Stankevicius, E.
dc.contributor.author Uvarovas, V.
dc.contributor.author Gelzinis, G.
dc.contributor.author Cepenas, M.
dc.contributor.author Andriukaitis, D.
dc.contributor.author Malekian, Reza
dc.date.accessioned 2015-05-20T06:07:38Z
dc.date.available 2015-05-20T06:07:38Z
dc.date.issued 2014
dc.description.abstract Goal directed fluid therapy (GDFT) implies the flow-related parameters guided infusion of fluids. It requires adherence to complex clinical algorithms and fluid protocols, as well as simultaneous monitoring of several parameters and evaluation of their fluid responsiveness or actual response to fluid challenges. Automated clinical decision support systems (ACDSS) are used to ease the task. However, they are based on the flow-related (hemodynamic) parameters – arterial blood pressure, cardiac output, etc. Meanwhile, infusions guided by hemodynamic endpoints may lead to edema. A mini Volume Loading Test (mVLT) may be helpful in detection of imminent edema from changes in hemodilution during stepwise infusion which is conventionally used for hemodynamic optimization. We developed an ACDSS which is based on evaluation of both hemodynamic and hemodilution parameters. It operates on the basis of our unique algorithm which implies interchangeable application of fluid loading, vasopressor injection and red cell transfusion. This ACDSS is used in our PC-based command centre of a prototype semi-closed loop (SCL) infusion system. We developed a simulator – ‘Virtual Patient’ – on the basis of our previous clinical records aiming to test a new controller, as well as train the research team before starting a clinical trial. In silico testing continued for 12 hours on five occasions. Primary endpoint was the compliance of a controller with our clinical algorithm and the stability of operation in a spectrum of arterial hypotension and bleeding scenarios. The prototype SCL infusion system was found ready for clinical validation. en_ZA
dc.description.librarian am2015 en_ZA
dc.description.sponsorship This research was funded by the European Union Funds (project No. VP1-3.1-ŠMM-10-V-02-014). Audrius Andrijauskas has received a consultant’s fee and travel funding from Masimo Corp. (Irvine, CA, USA). Also, AA received an honorarium from Masimo Corp. for an expert witness report. A.A. is an inventor in US patent US 7,788,045 B2, non-provisional US patent application US 61/470,224 and International non-provisional patent application US 13/973,747. en_ZA
dc.description.uri http://www.eejournal.ktu.lt/index.php/elt en_ZA
dc.identifier.citation Markevicius, V, Andrijauskas, A, Navikas, D, Dubauskiene, N, Porvaneckas, N, Stankevicius, E, Uvarovas, V, Gelzinis, G, Cepenas, M, Andriukaitis, D & Malekian, R 2014, 'In Silico testing of the semi-closed loop infusion system with a new simulator', Elektronika ir Elektrotechnika, vol. 20, no. 9, pp. 1-6. en_ZA
dc.identifier.issn 1392-1215 (print)
dc.identifier.issn 2029--5731 (online)
dc.identifier.other 10.5755/j01.eee.20.9.8520
dc.identifier.uri http://hdl.handle.net/2263/45178
dc.language.iso en en_ZA
dc.publisher Kaunas University of Technology en_ZA
dc.rights Kaunas University of Technology en_ZA
dc.subject Closed-loop en_ZA
dc.subject Medical simulator en_ZA
dc.subject Decision support system en_ZA
dc.subject Goal directed fluid therapy (GDFT) en_ZA
dc.subject mini Volume Loading Test (mVLT) en_ZA
dc.subject Automated clinical decision support systems (ACDSS) en_ZA
dc.title In Silico testing of the semi-closed loop infusion system with a new simulator en_ZA
dc.type Article en_ZA


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