Physiological Closed-Loop Control (PCLC) Systems: Review of a Modern Frontier in Automation

TL;DR

This review discusses recent advances, challenges, and future directions in physiological closed-loop control systems, focusing on artificial pancreas and automated anesthesia, highlighting their significance in improving medical automation and patient care.

Contribution

It provides a comprehensive overview of the current state, technological developments, and challenges in PCLC systems, emphasizing two key applications: artificial pancreas and automated anesthesia.

Findings

Advances in control algorithms for PCLCs.

Identification of key challenges in clinical implementation.

Future research directions for PCLC technology.

Abstract

Over the past decade, there has been an unprecedented international focus on improved quality and availability of medical care, which has reignited interest in clinical automation and drawn researchers toward novel solutions in the field of physiological closed-loop control systems (PCLCs). Today, multidisciplinary groups of expert scientists, engineers, clinicians, mathematicians, and policy-makers are combining their knowledge and experience to develop both the next generation of PCLC-based medical equipment and a collaborative commercial/academic infrastructure to support this rapidly expanding frontier. In the following article, we provide a robust introduction to the various aspects of this growing field motivated by the recent and ongoing work supporting two leading technologies: the artificial pancreas (AP) and automated anesthesia. Following a brief high-level overview of the main concepts in automated therapy and some relevant tools from systems and control theory, we explore -- separately -- the developments, challenges, state-of-the-art, and probable directions for AP and automated anesthesia systems. We then close the review with a consideration of the common lessons gleaned from these ventures and the implications they present for future investigations and adjacent research.