Comparison among manual, computer-assisted, and closed-loop control of blood pressure after cardiac surgery

• HIT Description: Computerized decision support with artificial intelligence. More info...
  
• Purpose of Study: Compare manual, computer-assisted, and closed-loop control of blood pressure.
  
• Years of study: Not Available
  
• Study Design: RCT
  
• Outcomes: Impact on health care effectivness/quality
  

• Settings: Forty-five patients who required vasodilator therapy for systemic arterial hypertension following cardiac surgery
• Intervention: The study groups were: (1) manual control of a sodium nitroprusside (SNP) infusion; (2) computer-assisted control where the nurse was provided with a color graphical display of performance; or (3) closed-loop control computer system.
• Evaluation Method: Measures of blood pressure control.
• Quality of Care and Patient Safety Outcome: The closed-loop computer system (CLCS) produced significantly better control than either manual or computer-assisted systems for the time spent outside the prescribed limits (P less than 0.001), and better control for the time spent outside the limits +/- 10 mmHg (manual P less than 0.001; assisted P less than 0.01). While the CLCS proved more satisfactory than manual control for the limits +/- 20 mmHg and +/- 30 mmHg (+/- 20 mmHg P less than 0.001; +/- 30 mmHg P less than 0.01), there was no significant difference in the quality of control between the CLCS and computer-assisted systems for these limits.