In Silico Testing of the Semi-Closed Loop Infusion System with a New Simulator

Abstract

However, there is evidence that hemodynamic optimization may not be sufficient for achieving the better results of treatment. Although benefits of GDFT were prevailing in early reports [1], the more recent data showed no benefit [6] or even worse outcomes [7].These controversial findings may find explanation in the following. An ultimate goal of optimized circulation is maintaining or improving organ perfusion and oxygen delivery to tissues. Thus, swelling of tissues (edema) is a concern. Volume kinetics indicated that 65 %-70 % of crystalloid solution usually remains in blood vessels at the end of infusion, whereas only 20 %-25 % remains therein 20 min later [8]. Most of the volume which leaves circulation soon after infusion is translocated into tissues. However, conventional clinical methods are not sufficiently sensitive and specific for the detection of when the necessary fluid accumulation in tissues turns into edema during hemodynamic optimization by fluids. Thus, a mini Volume Loading Test (mVLT) for detection of imminent edema during stepwise infusion was proposed

Closed-Loop Controlled Fluid Administration Systems: A Comprehensive Scoping Review

“…Due to the scope of this review, systems that were meant for vasopressor infusion control were not included, and only the fluid management component was addressed in the cases where both fluid management and vasopressor control were described. Two exceptions were the systems described by Libert et al [ 27 , 28 ] and by Markevicius et al [ 29 , 30 ], where these two components were essentially inseparable.…”