EA21 Newsletter: Can robots perform anaesthesia?

Session 01L1 – Friday December 17, 15:15 – 16:00  – Channel 5

This lecture on future technology will be given during Friday afternoon’s sessions by Dr Alexandre Joosten, Department of Anesthesiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.

“As most of us are aware, almost every facet of our society is becoming, for better or worse, progressively more technology-dependent. Technological advancement has made autonomous systems, also known as robots or “closed-loop” systems, an integral part of our life in several fields, including medicine,” says Dr Joosten. “In anaesthesia, the optimisation of perioperative administration of anaesthetic drugs along with intravenous fluids and vasopressor administration via manual titration using clinical judgement and weight-dosing calculations are all part of the various mundane but time- and attention-consuming activities that anaesthesiologists are required to do, on a daily basis.”

As all these actions are repetitive and require constant vigilance and they are susceptible to human error. In addition, they are associated with a significant amount of inter-and intra-practitioner variability. Physiologic closed-loop systems (PCLS) are “medical devices wherein a controller monitors one or more variables and adjusts one or more interventions using a feedback process”.

“Our academic hospital (Erasme Hospital, Brussels, Belgium) was one of the first to develop and use computer-controlled intravenous drug delivery systems. Since then, our hospital has always been at the forefront of the development of automated systems in anaesthesia,” explains Dr Joosten. “We started in 2011 with a novel PCLS to deliver high-quality “goal-directed fluid-therapy” (GDFT) in the operating room. We demonstrated that this closed-loop system is able to improve patient outcome in those who underwent major abdominal surgery.”

He concludes: “Our attention now turns to patients in the intensive care or operating room who physicians determine are in need of vasopressor infusions to correct hypotension, a serious predictive factor of postoperative morbidity and mortality. Further studies have yet to be done to test the combination of multiple PCLS to maintain simultaneously the homeostasis of multiple physiological variables and to test the safety of such combination on a large-scale population.”

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