Monitoring Inputs, Control Architectures, and Failure Modes in Closed-Loop Vasopressor Systems: A Comprehensive Review

Vitor Felippe; Hiorrana Sousa Dias; Carlos Darcy Alves Bersot; Gustavo Guimaraes Torres; Bruno Wegner; Gabriel Lemos González; Gustavo Wegner; Marcos Adriano Lessa

doi:10.3390/s26072180

Back

Monitoring Inputs, Control Architectures, and Failure Modes in Closed-Loop Vasopressor Systems: A Comprehensive Review

Journal article

Open access

Peer reviewed

Monitoring Inputs, Control Architectures, and Failure Modes in Closed-Loop Vasopressor Systems: A Comprehensive Review

Vitor Felippe, Hiorrana Sousa Dias, Carlos Darcy Alves Bersot, Gustavo Guimaraes Torres, Bruno Wegner, Gabriel Lemos González, Gustavo Wegner and Marcos Adriano Lessa

Sensors (Basel, Switzerland), Vol.26(7), 2180

04/01/2026

DOI: 10.3390/s26072180

PMCID: PMC13075136

PMID: 41977964

Files and links (1)

url

https://doi.org/10.3390/s26072180View

Published (Version of record) Open Access

Abstract

Closed-loop vasopressor systems integrate real-time blood pressure monitoring with automated decision logic to support hemodynamic stability in perioperative and critical care environments. These technologies sit at the intersection of biomedical sensing, signal processing, and clinician-supervised automation: the quality, latency, and failure behavior of the monitoring input can directly shape controller performance, safety margins, and clinical usability. In this comprehensive review, we synthesize the major closed-loop vasopressor architectures reported in the literature, examine how sensor modality and signal integrity influence algorithm behavior, and summarize recurrent reliability vulnerabilities spanning sensors, control logic, and device integration. We organize the field through an end-to-end information pipeline—monitoring input, signal conditioning and quality assessment, decision and control strategy, actuation via infusion technology, and supervisory safety layers—highlighting common performance metrics used to benchmark control quality. We then discuss clinical validation patterns across settings, emphasizing practical considerations for deployment and the evidence gaps that remain most relevant to high-risk populations. Finally, we propose reporting and validation priorities for future studies, with a focus on sensor robustness, transparency of algorithm design, integration safeguards, and standardized documentation of failures and overrides.

Automation

closed-loop control

failure modes

hemodynamic monitoring

perioperative technology

reliability

signal integrity

vasopressor

Details

Title: Subtitle: Monitoring Inputs, Control Architectures, and Failure Modes in Closed-Loop Vasopressor Systems: A Comprehensive Review
Creators: Vitor Felippe - Instituto Nacional de Câncer - INCA
Hiorrana Sousa Dias - Unichristus
Carlos Darcy Alves Bersot - Universidade Paulista
Gustavo Guimaraes Torres - Hospital Universitário Pedro Ernesto
Bruno Wegner - University of Rio Grande and Rio Grande Community College
Gabriel Lemos González - Universidade Federal do Estado do Rio de Janeiro
Gustavo Wegner - Universidade Federal da Fronteira Sul
Marcos Adriano Lessa - University of Iowa
Resource Type: Journal article
Publication Details: Sensors (Basel, Switzerland), Vol.26(7), 2180
DOI: 10.3390/s26072180
PMID: 41977964
PMCID: PMC13075136
NLM abbreviation: Sensors (Basel)
ISSN: 1424-8220
eISSN: 1424-8220
Publisher: MDPI
Language: English
Date published: 04/01/2026
Academic Unit: Anesthesia
Record Identifier: 9985153548602771

Metrics

1 Record Views