The first object oriented monitor for intravenous anesthesia.

OBJECTIVE: To describe the design and implementation of "INFUSION TOOLBOX," a software tool to control and monitor multiple intravenous drug infusions simultaneously using pharmacokinetic and pharmacodynamic principles. METHODS: INFUSION TOOLBOX has been designed to present a graphical interface. Object Oriented design was used and the software was implemented using Smalltalk, to run on a PC. Basic tools are available to manage patient, drugs, pumps and reports. These tools are the PatientPanel, the DrugPanel, the PumpPanel and the HistoryPanel. The screen is built dynamically. The panels may be collapsed or closed to avoid a crowded display. We also built control panels such as the Target ControlPanel which calculates the best infusion sequence to bring the drug concentration in the plasma compartment to a preset value. Before drug delivery, the user enters the patient's data, selects a drug, enters its dilution factor and chooses a pharmacokinetic model. The calculated plasma concentration is continually displayed and updated. The anesthetist may ask for the history of the delivery to obtain a graphic report or to add events to the logbook. A panel targeting the effect is used when a pharmacodynamic model is known. Data files for drugs, pumps and surgery are upgradable. DISCUSSION: By creating a resizeable ControlPanel we enable the anesthetist to display the information he wishes, when he wishes it. The available panels are diverse enough to meet the anesthetist needs; they may be adapted to the drug used, pumps used and surgery. It is the anesthetist who builds dynamically its different control screens. CONCLUSION: By adopting an evolutionary solution model we have achieved considerable success in building our drug delivery monitor. In addition we have gained valuable insight into the anesthesia information domain that will allow us to further enhance and expand the system.

Integration of a blood pressure controller and an infusion toolbox system using client-server technology.

This paper shortly describes an Infusion Toolbox and a blood pressure (BP) control application. It explains how we applied an agent model and client-server technology to integrate them. We show that by using this framework and object oriented technologies the necessary changes to the existing applications are reduced. Many elements of the tested original systems could be re-used, which enhances safe development.

Management software for a universal device communication controller: application to monitoring and computerized infusions.

We designed a virtual device for a local area network observing, operating and connecting devices to a personal computer. To keep the widest field of application, we proceeded by using abstraction and specification rules of software engineering in the design and implementation of the hardware and software for the Infusion Monitor. We specially built a box of hardware to interface multiple medical instruments with different communication protocols to a PC via a single serial port. We called that box the Universal Device Communication Controller (UDCC). The use of the virtual device driver is illustrated by the Infusion Monitor implemented for the anaesthesia and intensive care workstation.

Safety factors in the remote control of infusion devices.

We have been using computer driven injections in surgery for many years to the benefit of more than thousand patients. Along these years we accumulated extensive experience in remote controlled infusion pumps. Today we have solved many communication problems. Despite the attention and care we brought in our software developments we still meet with some problems.