title: Nonlinear model-based predictive control of non-depolarizing muscle relaxants using neural networks.
abstract: Neuromuscular blockade can be relatively easily measured in the clinical setting. Consequently, closed-loop control can be exercised by measuring the neuromuscular activity, calculating the dose of drug necessary to achieve a predefined degree of neuromuscular blockade and finally directing an infusion pump. Recently introduced short-acting blocking agents like mivacurium provide benefits for the clinical routine due to a small onset time and half life. In order to provide a stable blockade for different groups of patients a fast and highly adaptable control unit is needed. Furthermore its development should not imply costly investigations for determining a pharmacological model. The fulfilling of these requirements yield a self-adapting model-based predictive control system. The application of artificial neural networks allows an appropriate adjustment of specific parameters without the knowledge of inner pharmacodynamic processes. In a clinical study the EMG module within a Datex AS/3 monitor was used to measure the blockade and a Grasepy 3500 infusion pump for i.v. administration of mivacurium to 35 patients (ASA I-III). The performance of the novel system (mean of the T1 error: -0.32 +/- 1.7) compares favourably with closed-loop controllers demonstrated in the past. These promising results and the easy adaption to other blocking agents encourage to apply this technology even for delivering hypnotic drugs.
authors.affiliation: Department of Theoretical Foundations of Electrical Engineering, University of Erlangen-Nuremberg, Erlangen, Germany. lendl@late.e-technik.uni-erlangen.de
authors.forename: M
authors.initials: M
authors.lastname: Lendl
authors.forename: U H
authors.initials: UH
authors.lastname: Schwarz
authors.forename: H J
authors.initials: HJ
authors.lastname: Romeiser
authors.forename: R
authors.initials: R
authors.lastname: Unbehauen
authors.forename: M
authors.initials: M
authors.lastname: Georgieff
authors.forename: G F
authors.initials: GF
authors.lastname: Geldner
mesh_terms: D004576:Electromyography; D006801:Humans; D007546:Isoquinolines; D000077590:Mivacurium; D016571:Neural Networks, Computer; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents
chemical_list: D007546:Isoquinolines; D003473:Neuromuscular Nondepolarizing Agents; D000077590:Mivacurium