Development of an automated closed-loop β-blocker delivery system to stably reduce myocardial oxygen consumption without inducing circulatory collapse in a canine heart failure model: a proof of concept study
| العنوان: | Development of an automated closed-loop β-blocker delivery system to stably reduce myocardial oxygen consumption without inducing circulatory collapse in a canine heart failure model: a proof of concept study |
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| المؤلفون: | Masaru Sugimachi, Kazunori Uemura, Takuya Nishikawa, Toru Kawada, Yohsuke Hayama, Keita Saku |
| المصدر: | Journal of Clinical Monitoring and Computing. 36:849-860 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Cardiac output, Circulatory collapse, medicine.drug_class, Adrenergic beta-Antagonists, Hemodynamics, Health Informatics, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Proof of Concept Study, 03 medical and health sciences, Dogs, Oxygen Consumption, 0302 clinical medicine, 030202 anesthesiology, Internal medicine, medicine, Animals, Humans, Cardiac Output, Beta blocker, Heart Failure, business.industry, Central venous pressure, Shock, Landiolol, medicine.disease, Anesthesiology and Pain Medicine, Blood pressure, Heart failure, Cardiology, business, medicine.drug |
| الوصف: | Beta-blockers are well known to reduce myocardial oxygen consumption (MVO2) and improve the prognosis of heart failure (HF) patients. However, its negative chronotropic and inotropic effects limit their use in the acute phase of HF due to the risk of circulatory collapse. In this study, as a first step for a safe β-blocker administration strategy, we aimed to develop and evaluate the feasibility of an automated β-blocker administration system. We developed a system to monitor arterial pressure (AP), left atrial pressure (PLA), right atrial pressure, and cardiac output. Using negative feedback of hemodynamics, the system controls AP and PLA by administering landiolol (an ultra-short-acting β-blocker), dextran, and furosemide. We applied the system for 60 min to 6 mongrel dogs with rapid pacing-induced HF. In all dogs, the system automatically adjusted the doses of the drugs. Mean AP and mean PLA were controlled within the acceptable ranges (AP within 5 mmHg below target; PLA within 2 mmHg above target) more than 95% of the time. Median absolute performance error was small for AP [median (interquartile range), 3.1% (2.2–3.8)] and PLA [3.6% (2.2–5.7)]. The system decreased MVO2 and PLA significantly. We demonstrated the feasibility of an automated β-blocker administration system in a canine model of acute HF. The system controlled AP and PLA to avoid circulatory collapse, and reduced MVO2 significantly. As the system can help the management of patients with HF, further validations in larger samples and development for clinical applications are warranted. |
| تدمد: | 1573-2614 1387-1307 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3b734642dedcfb9a6f25ddbdcf286f44 https://doi.org/10.1007/s10877-021-00717-w |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3b734642dedcfb9a6f25ddbdcf286f44 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 15732614 13871307 |
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