Project

Back to overview

Continuous Monitoring of Anesthetics Concentration to Control Anesthesia Delivery (acronym: CoMofA)

English title Continuous Monitoring of Anesthetics Concentration to Control Anesthesia Delivery (acronym: CoMofA)
Applicant Carrara Sandro
Number 157139
Funding scheme Project funding
Research institution Laboratoire des systèmes intégrés EPFL - IC - ISIM - LSI
Institution of higher education EPF Lausanne - EPFL
Main discipline Clinical Pharmacology
Start/End 01.03.2015 - 28.02.2018
Approved amount 625'000.00
Show all

All Disciplines (2)

Discipline
Clinical Pharmacology
Microelectronics. Optoelectronics

Keywords (6)

drug-monitoring; nano-bio-chip; continuous-monitoring; anesthetics; carbon nanotubes; control-flow

Lay Summary (Italian)

Lead
Titolo del progetto di ricercaMonitoraggio continuo della concentrazione di anestetici al fine di assicurare un’anestesia controllata
Lay summary

In sintesi

Ogni anno, 30.000 persone subiscono un’anestesia parziale e, purtroppo, rimangono svegli, sentendo ancora dolore, pur non essendo più in grado di muoversi, a causa di una somministrazione difettosa del farmaco. Al contrario, altri pazienti sono messi in un inutile, profondo o prolungato stato di coma chimico. Un’anestesia corretta richiede il raggiungimento di un’ottimale quantità nel sangue dei farmaci usati per l’anestesia. Oggi, questi farmaci sono somministrati con sistemi d’iniezione controllata basati su modelli di controllo. che, però, sono soggetti ad elevati errori di previsione a causa della diversità tra i pazienti.

 

Soggetto e obiettivo

Obiettivo di questo progetto è, dunque, lo sviluppo di un primo sistema per il monitoraggio in continuo di agenti anestetici che circolano nei fluidi corporei al fine di un dosaggio più corretto dei farmaci impiegati in anestesia. Cuore del sistema saranno diversi sensori elettrochimici usati per il monitoraggio in continua di anestetici e sedativi in contemporanea con la somministrazione. Questi sensori forniranno poi dati ad algoritmi decisionali intelligenti in grado di suggerire adeguati dosaggi e tempi di rilascio degli anestetici.

 

Contesto socio-scientifico

Un tale sistema contribuirà certamente a migliorare la gestione dei pazienti sottoposti a chirurgia. I pazienti potranno beneficiare di un’anestesia più sicura e tempi di risveglio e recupero più veloci. Un maggiore controllo nell’anestesia può consentire interventi chirurgici in camera doppia con conseguente riduzione dei costi per ospedali ed assicurazioni, oltre al risparmio conseguente al sovradosaggio evitato del farmaco. Infine, una più sicura di anestesia ridurrà al minimo gli incidenti e, di conseguenza, eventuali azioni legali.

 

Parole chiave

Controllo di farmaci, sensori nanometrici, monitoraggio in continua, anestetici, nanotube al carbonio, sistemi di controllo per il flusso

Direct link to Lay Summary Last update: 26.01.2015

Responsible applicant and co-applicants

Employees

Publications

Publication
Long-Term Drug Monitoring of Propofol and Fouling Effect on Pencil Graphite Electrodes
Francesca Stradolini, Tugba Kilic, Alberto Di Consiglio, Mehmet Ozsoz, Giovanni De Micheli, Sandro Carrara (2018), Long-Term Drug Monitoring of Propofol and Fouling Effect on Pencil Graphite Electrodes, in Electroanalysis, 30, 1-8.
Raspberry Pi Based System for Portable and Simultaneous Monitoring of Anesthetics and Therapeutic Compounds
Francesca Stradolini, Abuduwaili Tuoheti, Paolo Motto Ros, Danilo Demarchi, Sandro Carrara (2017), Raspberry Pi Based System for Portable and Simultaneous Monitoring of Anesthetics and Therapeutic Compounds, in Proceedings of the international IEEE conference NGCAS 2017, Genoa (Italy)IEEE, Genoa (Italy).
Architecture and Procedures for pH and Temperature Monitoring in Medical Applications
Francesca Stradolini, Sofia Lydia Ntella, Abuduwaili Tuoheti, Danilo Demarchi, Alkis A. Hatzopoulos, Sandro Carrara (2017), Architecture and Procedures for pH and Temperature Monitoring in Medical Applications, in Proceedings of the IEEE Sensors Conference , GlasgowIEEE, Glasgow.
Raspberry Pi Driven Flow-Injection System for Electrochemical Continuous Monitoring Platforms
Bruno Donato, Francesca Stradolini, Abuduwaili Tuoheti, Federico Angiolini, Danilo Demarchi, Giovanni De Micheli, Sandro Carrara (2017), Raspberry Pi Driven Flow-Injection System for Electrochemical Continuous Monitoring Platforms, in IEEE BioCAS Conference, TurinIEEE, Turin.
Raspberry Pi Driven Flow-Injection System for Electrochemical Continuous Monitoring Platforms
Francesca Stradolini, Abuduwaili Tuoheti, Danilo Demarchi, Federico Angiolini, Giovanni De Micheli, Bruno Donato, Sandro Carrara (2017), Raspberry Pi Driven Flow-Injection System for Electrochemical Continuous Monitoring Platforms, in International conference BioCAS, TurinIEEE, Turin.
FPGA-based Approach for Automatic Peak Detection in Cyclic Voltammetry
Marius Schirmer, Francesca Stradolini, Sandro Carrara, Elisabetta Chicca (2016), FPGA-based Approach for Automatic Peak Detection in Cyclic Voltammetry, in 23rd IEEE International Conference on Electronics, Circuits and Systems (ICECS), Monte Carlo IEEE, Monte Carlo.
Paradigm-Shifting Players for IoT: Smart-Watches for Intensive Care Monitoring
Stradolini Francesca, Lavalle Eleonora, De Micheli Giovanno, Motto Paolo Ros, Demarchi Danilo, Carrara Sandro (2016), Paradigm-Shifting Players for IoT: Smart-Watches for Intensive Care Monitoring, in Proceedings of the 6th International Conference on Wireless Mobile Communication and Healthcare, European Alliance for Innovation, Milan (Italy).
Cascaded PID controller for anaesthesia delivery
Simalatsar Alena, Guidi Monia, Buclin Thierry (2016), Cascaded PID controller for anaesthesia delivery, in 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (E, Orlando, FL, USAIEEE, Orlando.
Simultaneous monitoring of anesthetics and therapeutic compounds with a portable multichannel potentiostat
Stradolini Francesca, Elboshra Tamador, Biscontini Armando, De Micheli Giovanni, Carrara Sandro (2016), Simultaneous monitoring of anesthetics and therapeutic compounds with a portable multichannel potentiostat, in 2016 IEEE International Symposium on Circuits and Systems (ISCAS), Montréal, QC, CanadaIEEE, Montreal.
Wireless Monitoring of Endogenous and Exogenous Biomolecules on an Android Interface
Stradolini Francesca, Riario Stefano, Boero Cristina, Baj-Rossi Camilla, Taurino Irene, Surrel Gregoire, De Micheli Giovanni, Carrara Sandro (2016), Wireless Monitoring of Endogenous and Exogenous Biomolecules on an Android Interface, in IEEE Sensors Journal, 16(9), 3163-3170.
IoT for Telemedicine Practices enabled by an AndroidTM Application with Cloud System Integration
Francesca Stradolini, Nadia Tamburrano, Thiébaud Modoux, Abuduwaili Tuoheti, Danilo Demarchi, Sandro Carrara, IoT for Telemedicine Practices enabled by an AndroidTM Application with Cloud System Integration, in IEEE Conference ISCAS 2018 , FlorenceIEEE, Florence.
Performance of Carbon Nano-Scale Allotropes in Detecting Midazolam and Paracetamol in Undiluted Human Serum
Francesca Stradolini, Nima Aliakbari, Sattar Akbari Nakhjavani, Ioulia Tzouvadaki, Irene Taurino, Giovanni De Micheli, Sandro Carrara, Performance of Carbon Nano-Scale Allotropes in Detecting Midazolam and Paracetamol in Undiluted Human Serum, in IEEE Sensors Journal.
Raspberry-Pi Based System for Propofol Monitoring
Francesca Stradolini, Tuoheti Abuduwaili, Tugba Kilic, Danilo Demarchi, Sandro Carrara, Raspberry-Pi Based System for Propofol Monitoring, in Integration, the VLSI Journal, 2018.

Collaboration

Group / person Country
Types of collaboration
Danilo Demarchi/Politecnico di Torino Italy (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
Ali Khademhosseini / Harvard Medical School (Boston) United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
Anthony Guiseppi-Elie/Clemson University(South Carolina) United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
IEEE NGCAS international Conference Talk given at a conference Keynote: Bio/Nano/CMOS interfaces for Remote Monitoring of Human Metabolism 09.09.2017 Genova, Italy Carrara Sandro;
Medi-Labo-Tech 2017 meeting Poster Target Controlled Infusion (TCI) of propofol could benefit from real-time concentration monitoring and closed loop control. 30.08.2017 Lausanne, Switzerland Carrara Sandro; Guidi Monia; Buclin Thierry; Simalatsar Alena;
workshop "Fundamentals and Applications of Microfluidic Compartmentalization", funded by OIST Individual talk Keynote: Integration of Bio/Nano/CMOS interfaces with Fluidics for Remote Monitoring of Human Metabolism 17.06.2017 Okinawa, Japan Carrara Sandro;
PAGE (Population approach group Europe) Poster Adequacy of open-loop Target Controlled Infusion devices during anesthesia 06.06.2017 Budapest, Hungary Buclin Thierry; Carrara Sandro; Guidi Monia; Simalatsar Alena;
IEEE ICECS international conference Talk given at a conference FPGA-based Approach for Automatic Peak Detection in Cyclic Voltammetry 12.12.2016 Montecarlo, France Carrara Sandro; Schirmer Marius; Stradolini Francesca;
MOBILHEALTH 2016 Talk given at a conference Paradigm-Shifting Players for IoT: Smart-Watches for Intensive Care Monitoring 03.11.2016 Milan, Italy Carrara Sandro; Stradolini Francesca;
International IEEE Conference ISCAS 2016 Talk given at a conference Simultaneous Monitoring of Anesthetics and Therapeutic Compounds with a Portable Multichannel Potentiostat 20.05.2016 Montreal, Canada Stradolini Francesca; Carrara Sandro;
IEEE PRIME Conference Talk given at a conference Keynote: Remote Metabolism Monitoring in Animal Models and Humans 03.07.2015 Glasgow, Great Britain and Northern Ireland Carrara Sandro;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Propofol in anaesthesia: Towards intelligent infusion pumps controlled by real-time blood concentration monitoring Poster 14.03.2018 Bern, Switzerland Buclin Thierry;
Invited lecture to Summer School at the Technical University of Dresden: Bio/Nano/CMOS interfaces for Ultrasensitive Memristive Biosensors Talk 11.09.2017 Dresden, Germany Carrara Sandro;
Target Controlled Infusion (TCI) of propofol could benefit from real-time concentration monitoring and closed loop control Poster 07.09.2017 Lausanne, Switzerland Buclin Thierry;
Adequacy of open-loop Target Controlled Infusion devices during anesthesia Poster 21.07.2017 Budapest, Switzerland Buclin Thierry;
Invited Turotial to IEEE International Conference on Circuits and Systems, ISCAS 2017: Bio/Nano/CMOS interfaces for Remote Monitoring of Human Metabolism Talk 28.05.2017 Baltimore, United States of America Carrara Sandro;
Invited talk provided to DroidconSmart-Watches as paradigm-shifting player in IoT Talk 15.04.2017 Milan, Italy Stradolini Francesca;
Invited Turorial to International IEEE Conference BioCAS 2016: System-In-Package and System-On-Chip for Remote Monitoring of Human Metabolism Talk 17.10.2016 Shanghai , China Carrara Sandro;
Invited Lecture to STAR-CAS 2015, a IEEE CAS outreach initiative on series of lectures on Advanced Research on Circuits and Systems: New perspectives in Telemetry of Metabolism Talk 15.04.2015 Pavia, Italy Carrara Sandro;


Communication with the public

Awards

Title Year
Golden Leaf Award for best paper, @ IEEE international Conference NGCAS, Genoa, Italy, 6-9 September 2017 2017
2016 IEEE Sensors Council Technical Achievement Advance Career Award for the leadership in the emerging area of co-design in Bio/Nano/CMOS interfaces for sensing 2016
Best Paper Award @ the international conference MOBIHEALTH, Milan (Italy) 2016
Elevation to the grade of IEEE Fellow for his outstanding record of accomplishments in the field of design of nanoscale biological CMOS sensors (corresponding to the top 0.1% of the IEEE members) 2016

Associated projects

Number Title Start Funding scheme
127547 Innovative Enabling Micro-Nano-Bio-technologies for Implantable systems in molecular medicine and personalized therapy 01.01.2010 Sinergia
147694 Innovative Enabling Micro-Nano-Bio-technologies for Implantable systems in molecular medicine and personalized therapy - Project prolongation 01.08.2013 Sinergia

Abstract

Motivation: Every year, 30,000 people undergo anesthesia and remain awake, still feeling pain while not being able to move, due faulty drug administration. Many more are put into uselessly deep or prolonged chemical coma. Proper anesthesia requires the achievement of a certain target plasma concentration of the drugs (e.g. propofol, fentanyl or midazolam, etc.). Today, such drugs are regularly injected by Target Controlled Infusion (TCI) systems, while the usual magnitude of prediction errors in control models reaches 20-30% due to the patients’ diversity. Therefore, continuous monitoring of anesthetic agents circulating in body fluids would contribute to better individualization of patients’ management. Project Focus: We propose to create a system with a semi-closed-loop control for anesthesia delivery based on the anesthetics monitoring in human fluids. Core of the system will include several electrochemical sensors for the real-time monitoring of anesthetics and sedatives, and complementary intelligent decision-making algorithms able to adjust dosages and delivery rates according to the sensor measurements, under the ultimate control of anesthesiologists.Expected outcome: We aim to produce a prototype of a device implementing semi-closed-loop anesthesia delivery based on real-time measurements of anesthetics concentration. The prototype will be ready for clinical development, after appropriate animal testing.Methods: the proposed semi-closed loop prototype is logically divided into four parts, all addressed by the activities of the present project. Part I (responsible Main Applicant: S. Carrara)It develops the setup emulating changes of drugs concentration in patients’ fluids (e.g., plasma concentration) and the array of sensors (S1, S2... Sn) for monitoring concentration of anesthetics (e.g. propofol, fentanyl and midazolam). Part II (responsible Main Applicant: S. Carrara)This part provides the readout for the sensors of Part I, the system for data verification, suitable connectivity to control algorithms of Part III, and the user interfaces for enabling anesthesiologists to take actions.Part III (responsible Co-applicant T. Buclin)This part studies proper pharmacokinetic (PK) prediction-models based on the monitored anesthetics (e.g., propofol) to be implemented in the drive-software of Part IVPart IV (responsible co-applicant J. Sifakis)This part builds appropriate drive-software algorithms to be implemented in programmable pumps, for dose adjustment based on classical proportional-integral-derivative (PID) and on the pharmacokinetic (PK) prediction-models developed in Part III
-