# Model Predictive Control and Its Role in Biomedical Therapeutic Automation: A Brief Review
## 3 MPC in Biomedical Applications
### Anaesthesia
The following are some of the multifaceted advantages of automated anaesthetic delivery systems:  
* Optimization of drug dose regimen;
* Better efficiency as compared to manual control;
* Chances of unintended under- or over-dosing are reduced;
* Clinicians can receive early alerts in case a crucial event occurs with the patient, allowing the clinician to intervene as soon as possible;
* Decision support is provided to the anaestologist in the form of a recommended optimal drug infusion determined using context-aware methods;  
Figure 9: NMPC closed-loop structure in anaesthesia. * Reduction of the workload of clinicians while increasing the effectiveness and vigilance of anesthesiologists. This allows the physician to devote more attention to decisions that demand human expertise;
* Effectiveness in terms of cost, including the avoidance of repetitive treatment and saving costs by achieving accurately targeted drug delivery. Cyber Physical Human Systems  
Figure 10 depicts a schematic representation of a cyber-physical-human system in healthcare. For the anaesthesiologist, an intelligent control architecture can be designed to avoid repetitive tasks, such as constantly monitoring the state of the patient or adhering to well-defined international standards. There are also new issues arising from the COVID-19 pandemic, such as sudden cardiac arrest and arrhythmias, which need to be addressed [87]. With the smart controllers handling routine anaesthesia tasks with satisfactory effectiveness, medical personnel have more time to attend to other vital obligations. In this way, the automation of general sedation regulation may be realised in operation theatres and intensive care units (ICU) alike. While administering anaesthesia, the patient's condition is constantly monitored, and the dosage of drug is adjusted accordingly. When it comes to administering medication by computer, open-loop target-controlled infusion systems (TCI) are used as a first step. Using pharmacokinetics principles, TCIs keep the anaesthetic infusion within predefined limits [88]. To be extra certain, the anaesthesiologist is made a part of the closed-loop control by setting the initial dosage set point targets and then manipulating them in accordance with the patient's state of anaesthesia and health parameters. Patients' responses to medications are predicted by doctors based on data from monitoring equipment, clinical judgement and prior experience. Closed-loop automated control systems, on the other hand, automatically adjust drug infusion rates based on measurements of anaesthesia depth taken from the patient directly. The controller receives constant feedback from the patient's measured bio-responses. This upgrades the role of anaesthesiologists to a higher level, such as the monitoring of patient-specific physiological parameters and/or responding to emergency situations for special drug delivery cases. Figure 10: The potential of a cyber-physical-human system (CPHS) in anaesthesia [86]. Figure 11 presents an anaesthesia process schematic including manual as well as computerised closed-loop control and optimization. The automated closed-loop control system monitors the effect of the drug via measured bio-parameters (multi-outputs) of the patient and regulates multiple drug infusions (multi-inputs). By actively operating on patients as needed in order to keep medication delivery systems running well, anaesthesiologists have a direct impact on the system. Patient dynamics, surgeon's actions, anaest actions, syringe pump outputs, sensor data collection, and syringe pump actuators are all components of the anaesthesia system that can be modelled in a control loop. Using these components, the entire process can be simulated, allowing surgeons and anaesthesiologists to better understand and control their patients' medical hypnosis. Clinical expertise and automatic closed-loop control and optimization can be interlinked to ensure optimal drug delivery to the patients.