Clinical application of a blood pressure autoregulation system during hypotensive anesthesia.
A blood pressure autoregulation system based on the state-predictive control method was developed to minimize intraoperative blood loss and hence avoid blood transfusion. In this report, the system is further improved by incorporating fuzzy logic with a fail-safe function and an individual parameter-identifying function. The safety and stability of this system had been confirmed by preclinical experiments with dogs. Thereafter clinical application with 17 patients was conducted to maintain their mean arterial pressure at around 60 mmHg during major surgery. The use of this system resulted in decreased blood loss and more speedy and accurate surgery due to a clearer surgical field. Unwanted effects of hypotension were not observed clinically or in laboratory tests. This system is therefore safe, stable, and effective in reducing the blood loss during major surgery that otherwise might cause substantial blood loss.
Onodera
H
H
Department of Surgery and Surgical Basic Science, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Maetani
S
S
Aung
T
T
Kan
S
S
Sakamoto
T
T
Shiragami
G
G
Furutani
E
E
Araki
M
M
Imamura
M
M
D000758:Anesthesia / Q000379:methods*; D000804:Angiotensin II / Q000032:analysis; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery; D017143:Fuzzy Logic; D006801:Humans; D007023:Hypotension, Controlled / Q000379:methods*; D015850:Interleukin-6 / Q000032:analysis; D007677:Kidney Function Tests; D008111:Liver Function Tests; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D018709:Statistics, Nonparametric
D015850:Interleukin-6; D000804:Angiotensin II