Anesthesia & Analgesia has just published two peer-reviewed papers on the LIR system. The first is an engineering validation of the LIR algorithm showing that the system is stable across a large range of body weights, starting blood volumes, and cardiac contractility. The second is an in-vivo study in which the LIR system was compared to anesthesiologist management alone and assessed for performance and safety under critical conditions. PubMed links to the two manuscripts are below:
Human Case Series Published
A case series describing the first clinical cases where goal-directed fluid management was performed with the assistance of the closed-loop system has been published in Annales Françaises d’Anesthésie et de Réanimation.
The article is available through the French Journal of Anesthesiology.
Two peer-reviewed articles on LIR Published in Anesthesia & Analgesia
Editorial Discussing LIR Research Published in the Journal Of Cardiovascular and Thoracic Anesthesia
An editorial by Dr. Gerard Manecke, chairman of the Department of Anesthesiology at the University of California, San Diego has just been published covering the article on LIR published two weeks ago in the journal. The editorial discusses the rationale for closed-loop systems in clinical care and takes a positive (but realistic) look at these technologies. Dr. Manacke states in the editorial:
…if the question is, “Is it possible to program a system to successfully automate GDT?” they have answered it with a resounding “yes.”…Automated medical care will be an important part of the future, and Dr Rinehart and his team are helping physicians get there.
A link to the online article is available on the journal website.
Simulation Study on LIR Algorithm Shows Efficacy Without Dynamic Predictors
A second simulation study using the LIR closed-loop fluid administration system has shown that the system does not require dynamic predictors of fluid responsiveness to perform well. Dynamic predictors are a relatively new set of physiologic measurements that help physicians guide fluid therapy during surgery and in the intensive care unit. Previous publications and presentations on the LIR algorithm have used these predictors to help guide fluid therapy. This new research has shown that the system is not dependent on these measurements and continues to perform well even if given only standard physiologic measurements to guide therapy. This research has been published in the Journal of Cardiovascular and Thoracic Anesthesia.
Simulation Data Shows LIR Closed-Loop Fluid Administration System Improves Anesthesiologist-Directed Resuscitation Performance
An in-silico study has just been published in the international journal Critical Care in which simulated patient resuscitations were managed by anesthesiologists. Use of the LIR closed-loop fluid administration system significantly improved resuscitation and better maintained patients within physiologically normal ranges than hand-directed performance. This publication in the prestigious peer-reviewed journal is a great validation of the potential utility of this system.
The article is open-access and available online: LIR Closed-Loop Fluid Administration System Simulation Study