The first object oriented monitor for intravenous anesthesia

Objective.To describe the design and implementation ofINFUSION TOOLBOX, a software tool to control and monitormultiple intravenous drug infusions simultaneously using pharmacokinetic andpharmacodynamic principles. Methods.INFUSION TOOLBOX has been designedto present a graphical interface. Object Oriented design was used and thesoftware was implemented using Smalltalk, to run on a PC. Basic tools areavailable to manage patient, drugs, pumps and reports. These tools are thePatientPanel, the DrugPanel, the PumpPaneland theHistoryPanel. The screen is built dynamically. The panels may becollapsed or closed to avoid a crowded display. We also built control panelssuch as the Target ControlPanelwhich calculates the best infusionsequence to bring the drug concentration in the plasma compartment to a presetvalue. Before drug delivery, the user enters the patients data, selectsa drug, enters its dilution factor and chooses a pharmacokinetic model. Thecalculated plasma concentration is continually displayed and updated. Theanesthetist may ask for the history of the delivery to obtain a graphic reportor to add events to the logbook. A panel targeting the effect is used when apharmacodynamic model is known. Data files for drugs, pumps and surgery areupgradable. Discussion.By creating a resizeable ControlPanelwe enable the anesthetist to display the information he wishes, when hewishes it. The available panels are diverse enough to meet the anesthetistneeds; they may be adapted to the drug used, pumps used and surgery. It is theanesthetist who builds dynamically its different control screens.Conclusion.By adopting an evolutionary solution model we have achievedconsiderable success in building our drug delivery monitor. In addition wehave gained valuable insight into the anesthesia information domain that willallow us to further enhance and expand the system.