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. Metho ds. INFUSION TOOLBOX has been designed to present a graphical interface. Ob ject Oriented design was used and the software was implemented using Smallt alk, to run on a PC. Basic tools are available to manage patient, drugs, pu mps and reports. These tools are the PatientPanel, the DrugPanel, the PumpP anel and the HistoryPanel. The screen is built dynamically. The panels may be collapsed or closed to avoid a crowded display. We also built control pa nels such as the Target ControlPanel which calculates the best infusion seq uence 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 a nesthetist may ask for the history of the delivery to obtain a graphic repo rt or to add events to the logbook. A panel targeting the effect is used wh en a pharmacodynamic model is known. Data files for drugs, pumps and surger y are upgradable. Discussion. By creating a resizeable ControlPanelwe enabl e 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 anesthe tist who builds dynamically its different control screens. Conclusion. By a dopting an evolutionary solution model we have achieved considerable succes s in building our drug delivery monitor. In addition we have gained valuabl e insight into the anesthesia information domain that will allow us to furt her enhance and expand the system.