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Closed loop administration of remifentanil for monitored anesthesia care using PCO2 as endpoint


A. Caruso

ASA - American Society of Anesthesiologists Annual Meeting, Chicago, IL

Respiratory events are the most common complications of monitored anesthesia care (MAC). Opioids and propofol, frequently used in this setting, cause profound respiratory depression. In addition, light sedation is difficult to quantify. This is not the case for the partial pressure of CO2 (PCO2), the preferred marker of ventilation. Combined pulse oximetry/transcutaneous CO2 partial pressure (PtcCO2) sensors are commercially available. Therefore, targeting the pharmacologic side effect might be preferable to targeting the desired effect during MAC. We tested in a complex model of human metabolism and ventilation, whether a feedback PI controller targeting PtcCO2 values between 45 and 60 mmHg administering remifentanil would yield acceptable performance and safety.


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M. Morari

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