I began my anesthesia training in 1984 and did an anesthesia bioengineering research fellowship in 1986. Personal computers were relatively new at that time; but even then, smart alarms, electronic anesthesia records, and closed-loop control of inhaled anesthetics and hemodynamics seemed feasible. During my fellowship, I helped develop a prototype anesthesia workstation that detected anesthesia machine malfunctions and provided computer control of inhaled oxygen and anesthetic agent concentrations. It has taken 30 years for anesthesia workstations with closed-loop control of inhaled and exhaled gas concentrations to become commercially available, but none are currently marketed in the U.S.

Closed-loop feedback control of speed (i.e., cruise-control) is a standard feature on automobiles and has been for a while. Newer cars commonly have more sophisticated control systems that keep the vehicle within its lane and adaptively change its speed in traffic....

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