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. American drivers increasingly expect their cars to assist them during monotonous...

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