Impact of control on agitation-sedation dynamics

Agitation in the critically ill damages patient health and increases length of stay and healthcare costs. The control model presented captures the essential dynamics of the agitation-sedation system, and is statistically validated using recorded infusion data for 37 patients. Derivative focused control is seen to provide an essentially bolus-driven management approach, which is shown to be an effective means of managing agitation, given consistent agitation measurement. Improved agitation management using feedback of patient agitation reduces the modelled mean and peak agitation levels 68.4% and 52.9% on average, respectively, illustrating the effectiveness of simple control in this non-linear system.