The Hemodynamic Intelligence System: A Review of Closed-Loop Integration between Bedside Monitors, Biomarker Analysis, and Smart Infusion Pumps
Abstract
Background: The management of acute hemodynamic instability, particularly in sepsis and shock, remains a high-stakes challenge characterized by time-sensitive interventions and dynamic physiological changes. Recent technological advances in smart infusion pumps, continuous physiological monitoring, and rapid biomarker analysis present an unprecedented opportunity for integration.
Aim: This narrative review aims to synthesize the current evidence and conceptual frameworks for a Hemodynamic Intelligence System (HIS)—a closed-loop integration of bedside monitors, biomarker analysis, and smart infusion pumps—to enable autonomous, physiologically adaptive drug delivery for conditions like sepsis and shock.
Methods: A comprehensive literature search was conducted across PubMed, IEEE Xplore, CINAHL, and Web of Science for English-language articles published between 2010 and 2024.
Results: The convergence of these technologies is technically feasible and shows promise in early-stage clinical studies for improving protocol adherence and reducing time-to-therapeutic goals. Laboratory medicine must evolve to provide analyzers with sufficient rapidity and reliability for real-time feedback. Nursing faces a paradigm shift towards system oversight and alarm management, requiring new competencies in data interpretation and human-machine interaction.
Conclusion: The Hemodynamic Intelligence System represents a transformative vision for critical care. Its successful implementation hinges not on technological capability alone, but on rigorous interdisciplinary collaboration to address challenges in system safety, clinical workflow integration, and the preservation of the nurse's indispensable role as clinical contextualizer. Future research must prioritize robust clinical outcome trials and the development of shared governance models for autonomous systems.
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Authors
Copyright (c) 2024 Fahad Khalid Alotaibi, Mohammed ALeqidi Alruwili, Abdullah Maashi Harran Alruwili, Menwer Ata Maashi Alruwili, Zamil Ashwi Muhayris Alruwaili, Nasser Mohammed Albaqami, Rakan Ashwi Alruwaili, Hussein Nasser Mansour Aldawsari, Obaid Saad Aldwassary, Mohammed Mubarak Al-Shuraidah, Nader Awad R. Alotaibi, Mesfer Zaid Hathal Alkhamis, Eman Ali Mohammed Alrazqi, Zahra Jaber Majrashi
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