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. 2022 Jul 18;12(7):1168.
doi: 10.3390/jpm12071168.

Closed-Loop Controlled Fluid Administration Systems: A Comprehensive Scoping Review

Guy Avital  1   2   3 , Eric J Snider  1 , David Berard  1 , Saul J Vega  1 , Sofia I Hernandez Torres  1 , Victor A Convertino  1   4   5   6 , Jose Salinas  1 , Emily N Boice  1
Affiliations

Closed-Loop Controlled Fluid Administration Systems: A Comprehensive Scoping Review

Guy Avital et al. J Pers Med. .

Abstract

Physiological Closed-Loop Controlled systems continue to take a growing part in clinical practice, offering possibilities of providing more accurate, goal-directed care while reducing clinicians' cognitive and task load. These systems also provide a standardized approach for the clinical management of the patient, leading to a reduction in care variability across multiple dimensions. For fluid management and administration, the advantages of closed-loop technology are clear, especially in conditions that require precise care to improve outcomes, such as peri-operative care, trauma, and acute burn care. Controller design varies from simplistic to complex designs, based on detailed physiological models and adaptive properties that account for inter-patient and intra-patient variability; their maturity level ranges from theoretical models tested in silico to commercially available, FDA-approved products. This comprehensive scoping review was conducted in order to assess the current technological landscape of this field, describe the systems currently available or under development, and suggest further advancements that may unfold in the coming years. Ten distinct systems were identified and discussed.

Keywords: artificial intelligence; automated; autonomous; closed loop; controller; decision support; fluid management; fluid resuscitation; fluid therapy; scoping review.

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Conflict of interest statement

The authors (E.J.S., E.N.B., S.J.V., S.I.H.T., J.S.) developed the adaptive resuscitation controller that was identified and highlighted as part of this scoping review. J.S. is a co-inventor of the Burn Navigator system that was also identified and highlighted as part of this scoping review.

Figures

Figure 1
Figure 1
Flow diagrams describing physiological (A) Decision Support; (B) Provider-in-Loop; and (C) Closed-Loop controlled systems.
Figure 2
Figure 2
PRISMA-ScR Flow diagram of the scoping review format.
See this image and copyright information in PMC

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