Impact of control on agitation-sedation dynamics

Andrew D. Rudge; J. Geoffrey Chase; Geoffrey M. Shaw; Dominic Lee; Graeme C. Wake; Irene L. Hudson; Lucy Johnston

doi:10.1016/j.conengprac.2004.10.010

Impact of control on agitation-sedation dynamics

Andrew D. Rudge
, J. Geoffrey Chase
, Geoffrey M. Shaw
, Dominic Lee
, Graeme C. Wake
, Irene L. Hudson
, Lucy Johnston

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

Agitation in the critically ill damages patient health and increases length of stay and healthcare costs. The control model presented captures the essential dynamics of the agitation-sedation system, and is statistically validated using recorded infusion data for 37 patients. Derivative focused control is seen to provide an essentially bolus-driven management approach, which is shown to be an effective means of managing agitation, given consistent agitation measurement. Improved agitation management using feedback of patient agitation reduces the modelled mean and peak agitation levels 68.4% and 52.9% on average, respectively, illustrating the effectiveness of simple control in this non-linear system.

Original language	English
Pages (from-to)	1139-1149
Number of pages	11
Journal	Control Engineering Practice
Volume	13
Issue number	9
DOIs	https://doi.org/10.1016/j.conengprac.2004.10.010
Publication status	Published - Sept 2005
Externally published	Yes

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10.1016/j.conengprac.2004.10.010

Cite this

@article{a2f83d76a13f4ec5b4b6fcfbbadaeb35,

title = "Impact of control on agitation-sedation dynamics",

abstract = "Agitation in the critically ill damages patient health and increases length of stay and healthcare costs. The control model presented captures the essential dynamics of the agitation-sedation system, and is statistically validated using recorded infusion data for 37 patients. Derivative focused control is seen to provide an essentially bolus-driven management approach, which is shown to be an effective means of managing agitation, given consistent agitation measurement. Improved agitation management using feedback of patient agitation reduces the modelled mean and peak agitation levels 68.4\% and 52.9\% on average, respectively, illustrating the effectiveness of simple control in this non-linear system.",

keywords = "Biomedical control, Non-linear dynamics, Patient agitation, PD controllers, Physiological models, Sedation administration",

author = "Rudge, \{Andrew D.\} and Chase, \{J. Geoffrey\} and Shaw, \{Geoffrey M.\} and Dominic Lee and Wake, \{Graeme C.\} and Hudson, \{Irene L.\} and Lucy Johnston",

note = "Funding Information: The authors wish to acknowledge Kathryn Greenfield and Richard Dove from the Medical Engineering and Physics Department at Christchurch Hospital, and Assoc. Prof. David Wall from the Department of Mathematics and Statistics at the University of Canterbury for their input to this work. Funding for this research was provided by the New Zealand Foundation for Research, Science and Technology through a Bright Futures Top Achiever Doctoral Scholarship, and by the Todd Foundation through the Award for Excellence.",

year = "2005",

month = sep,

doi = "10.1016/j.conengprac.2004.10.010",

language = "English",

volume = "13",

pages = "1139--1149",

journal = "Control Engineering Practice",

issn = "0967-0661",

publisher = "Elsevier Limited",

number = "9",

}

TY - JOUR

T1 - Impact of control on agitation-sedation dynamics

AU - Rudge, Andrew D.

AU - Chase, J. Geoffrey

AU - Shaw, Geoffrey M.

AU - Lee, Dominic

AU - Wake, Graeme C.

AU - Hudson, Irene L.

AU - Johnston, Lucy

N1 - Funding Information: The authors wish to acknowledge Kathryn Greenfield and Richard Dove from the Medical Engineering and Physics Department at Christchurch Hospital, and Assoc. Prof. David Wall from the Department of Mathematics and Statistics at the University of Canterbury for their input to this work. Funding for this research was provided by the New Zealand Foundation for Research, Science and Technology through a Bright Futures Top Achiever Doctoral Scholarship, and by the Todd Foundation through the Award for Excellence.

PY - 2005/9

Y1 - 2005/9

N2 - Agitation in the critically ill damages patient health and increases length of stay and healthcare costs. The control model presented captures the essential dynamics of the agitation-sedation system, and is statistically validated using recorded infusion data for 37 patients. Derivative focused control is seen to provide an essentially bolus-driven management approach, which is shown to be an effective means of managing agitation, given consistent agitation measurement. Improved agitation management using feedback of patient agitation reduces the modelled mean and peak agitation levels 68.4% and 52.9% on average, respectively, illustrating the effectiveness of simple control in this non-linear system.

AB - Agitation in the critically ill damages patient health and increases length of stay and healthcare costs. The control model presented captures the essential dynamics of the agitation-sedation system, and is statistically validated using recorded infusion data for 37 patients. Derivative focused control is seen to provide an essentially bolus-driven management approach, which is shown to be an effective means of managing agitation, given consistent agitation measurement. Improved agitation management using feedback of patient agitation reduces the modelled mean and peak agitation levels 68.4% and 52.9% on average, respectively, illustrating the effectiveness of simple control in this non-linear system.

KW - Biomedical control

KW - Non-linear dynamics

KW - Patient agitation

KW - PD controllers

KW - Physiological models

KW - Sedation administration

UR - https://www.scopus.com/pages/publications/18144369301

U2 - 10.1016/j.conengprac.2004.10.010

DO - 10.1016/j.conengprac.2004.10.010

M3 - Article

AN - SCOPUS:18144369301

SN - 0967-0661

VL - 13

SP - 1139

EP - 1149

JO - Control Engineering Practice

JF - Control Engineering Practice

IS - 9

ER -

Impact of control on agitation-sedation dynamics

Abstract

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