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Closed-Loop Vasopressor in Neurointensive Critical Care




The research team behind the closed-loop vasopressor system published a new clinical trial report in neurointensive care patients. The study, titled "Control of Mean Arterial Pressure Using a Closed-Loop System for Norepinephrine Infusion in Severe Brain Injury Patients: The COMAT Randomized Controlled Trial" was published in the Journal of Clinical Monitoring & Computing last month.


In the study, patients who had suffered traumatic injuries were supported with either standard of care infusion management or infusions managed by the closed-loop vasopressor system. Study patients receiving closed-loop care experienced an average of 2.2% low blood pressure time compared to almost 27% in the standard of care group - a more than 10x reduction in risk exposure. Severe low-blood pressure time, defined at more than 10 mmHg below the target, was similarly reduced from 7.4% in the standard care group to 0.2% - an almost 40x reduction in risk exposure. Severe over-treatment was also reduced from 29% of management time to effectively 0% of time. Overtreatment is of special concern in this patient population because the bleeding risk in the presence of high blood pressure can be as devastating as the ischemic injury that can occur when pressure is too low.


This study adds to the supporting existing body of evidence of potential utility for closed-loop control in both the operating room as well as post-operative cardiac and post-operative surgical patients.

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