Physiological modelling of agitation-sedation dynamics

Med Eng Phys. 2006 Jan;28(1):49-59. doi: 10.1016/j.medengphy.2005.03.005.

Abstract

Agitation-sedation cycling in critically ill patients, characterized by oscillations between states of agitation and over-sedation, damages patient health and increases length of stay and cost. A model that captures the essential dynamics of the agitation-sedation system and is physiologically representative is developed, and validated using data from 37 critical care patients. It is more physiologically representative than a previously published agitation-sedation model, and captures more realistic and complex dynamics. The median time in the 90% probability band is 90%, and the total drug dose, relative to recorded drug dose data, is a near ideal 101%. These statistical model validation metrics are 5-13% better than a previously validated model. Hence, this research provides a platform to develop and test semi-automated sedation management controllers that offer the significant clinical potential of improved agitation management and reduced length of stay in critical care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Conscious Sedation*
  • Critical Care / methods*
  • Critical Illness / therapy*
  • Humans
  • Models, Biological
  • Models, Statistical
  • Monitoring, Physiologic*
  • Nonlinear Dynamics
  • Psychomotor Agitation / drug therapy*
  • Time Factors