Controls Review of PID Control of Neuromuscular Blockade

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Teresa Mendonca and Pedro Lago of The University of Porto published an article titled, “PID control strategies for the automatic control of neuromuscular blockade,” describing how modified digital PID controllers were designed for the neuromuscular blockade. A study was done on 30 patients using the digital PID control system where data was collected. The results were favorable suggesting individually tailored parameters in PID controllers. The article described how the PID was implemented, which parameters were changed, and how the changes affected the results. However, the authors were ambiguous as to the approach and assumptions made when working in a dynamic biological system. Generally, a digital PID controller can be successfully implemented in neuromuscular blockade.

Complex biological systems are complicated to model and difficult to produce accurate control systems when by nature biological systems are dynamic, non-linear, and are highly variable from patient to patient. The convoluted nature of the systems indicates a vigorous and reliable control system is desired. This paper targeted to have a control system for a neuromuscular blockade, which is defined as a muscle relaxant drug given during certain types of surgery. Neuromuscular transmitters are blocked by the drug, thus not allowing the muscle to depolarize, aiding the surgeon when working with relaxed muscle. A neuromuscular blockade representation is most commonly modeled by a linear pharmacokinetic model including drug infusion rate, plasma concentration, and induced pharmaco-dynamic responses. The variety of inputs necessary to model a neuromuscular blockade indicated to the authors multiple attempts with several methods would be compulsory to have a thrivin...

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...erent published article by Waite in 1987 titled, “Neuromuscular blockade” published in Anesthesia. Therefore the results by Mendonca and Largo were verified and confirmed, leading the audience to believe the results are valid. Raw data was not given in the paper so further analysis and confirmation of results would have been impossible. However, verification by other sources resulting in similar results, such as the paper published by Wait, make the article under critique more credible. (2)

The authors of this piece described the problem in detail and adequately discussed the development of the individually tailored digital PID control system. Further research and more clinical trials can help further the control system and have a new goal for no manual control of the neuromuscular blockade. Overall, this article gave excellent insight in digital PID controllers.

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