title: Closed-loop control of consciousness during lung transplantation: an observational study.
abstract: OBJECTIVE
  To determine if propofol infusion can be steered automatically by using bispectral index (BIS) as a controller during lung transplantation.
  
  
  METHODS
  A prospective study of patients undergoing lung transplantation.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twenty consecutive patients scheduled for bilateral (n = 14) or single (n = 6) lung transplantation.
  
  
  METHODS
  The goal of the closed-loop administration of propofol was to maintain the BIS value between 40 and 60 during the maintenance phase. The remifentanil infusion was adjusted according to standard clinical practice.
  
  
  RESULTS
  The closed-loop system was able to provide anesthesia maintenance for all patients. Cardiopulmonary bypass was used in 5 patients, and 14 patients received a thoracic epidural catheter. The BIS value was maintained between 40 and 60 during 84% +/- 16% of the maintenance phase. Eleven patients were extubated in the operating room, and 1 patient needed reintubation.
  
  
  CONCLUSIONS
  Closed-loop control of consciousness by a computer during lung transplantation is clinically feasible.
authors.affiliation: Department of Anesthesiology, Hôpital Foch, Suresnes, France.
authors.forename: Ngai
authors.initials: N
authors.lastname: Liu
authors.forename: Thierry
authors.initials: T
authors.lastname: Chazot
authors.forename: Bernard
authors.initials: B
authors.lastname: Trillat
authors.forename: Mireille
authors.initials: M
authors.lastname: Michel-Cherqui
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Marandon
authors.forename: Jean-Dominique
authors.initials: JD
authors.lastname: Law-Koune
authors.forename: Bertrand
authors.initials: B
authors.lastname: Rives
authors.forename: Marc
authors.initials: M
authors.lastname: Fischler
mesh_terms: D000293:Adolescent; D000328:Adult; D000764:Anesthesia, Closed-Circuit / Q000379:methods*; D003243:Consciousness / Q000187:drug effects / Q000502:physiology*; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D015742:Propofol