PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Automated system promises precise control of medically induced coma

Successful animal study may lead to computer-controlled general anesthesia delivery

2013-11-01
(Press-News.org) Contact information: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Automated system promises precise control of medically induced coma Successful animal study may lead to computer-controlled general anesthesia delivery Putting patients with severe head injuries or persistent seizures into a medically induced coma currently requires that a nurse or other health professional constantly monitor the patient's brain activity and manually adjust drug infusion to maintain a deep state of anesthesia. Now a computer-controlled system developed by Massachusetts General Hospital (MGH) investigators promises to automate the process, making it more precise and efficient and opening the door to more advanced control of anesthesia. The team, including colleagues from Massachusetts Institute of Technology (MIT), reports successfully testing their approach in animals in the open access journal PLOS Computational Biology.

"People have been interested for years in finding a way to control anesthesia automatically," says Emery Brown, MD, PhD, of the MGH Department of Anesthesia, Critical Care and Pain Medicine, senior author of the report. "To use an analogy that compares giving anesthesia to flying a plane, the way it's been done is like flying a direct course for hours or even days without using an autopilot. This is really something that we should have a computer doing."

As part of a long-term project investigating the physiological basis of general anesthesia, Brown's team at MGH and MIT has identified and studied patterns of brain activity reflecting various states of anesthesia. One of the deepest states called burst suppression is characterized by an electroencephalogram (EEG) pattern in which brief periods of brain activity – the bursts – are interrupted by stretches of greatly reduced activity that can last for seconds or longer. When patients with serious head injuries that cause a buildup of pressure within the skull or those with persistent seizures are put into a medically induced coma to protect against additional damage, the goal is to maintain brain activity in a state of burst suppression.

Although anesthesiologists have had computer-assisted technologies for many years, no FDA-approved system exists that completely controls anesthesia administration based on continuous monitoring of a patient's brain activity. Until the current study, Brown notes, no one had demonstrated the level of control required for a completely automated system. Keeping patients at a precise level of brain activity for several days, as required for medically induced coma, appeared to be both a feasible goal and one that cried out for the sort of computer-controlled system called a brain-machine interface.

Adapting programs they had previously developed to analyze the activity of neurons, Brown's team developed algorithms to read and analyze an EEG pattern in real time and determine a target level of brain activity – in this case the stage of burst suppression. Based on that target, an automated control device adjusts the flow of an anesthetic drug to achieve the desired brain state, and real-time analysis of the continuous EEG readings is fed back to the system to insure maintenance of the target. When the researchers tested their system in a rodent model, the actual EEG-based measure of burst suppression tracked the target trajectory almost exactly.

"As far as we know, these are the best results for automated control of anesthesia that have ever been published," says Brown, who is the Warren M. Zapol Professor of Anesthesia at Harvard Medical School and the Edward Hood Taplin Professor of Medical Engineering and Computational Neuroscience at MIT. "We're now in discussions with the FDA for approval to start testing this in patients." The MGH has also applied for a patent for the technology.

Among the benefits of such a system, Brown explains, would be the ability to maintain medical coma at a more precise, consistent level than can be done manually and using lower doses of anesthetic drugs, a reduction that is possible with any computer-assisted technology. Eliminating the need to devote one intensive-care nurse on each shift to continuous monitoring of one patient would significantly change ICU staffing needs. Further development of the system to control and maintain the full range of anesthesia states should introduce a powerful new tool to the entire field.

### Lead authors of the PLOS Computational Biology report are Maryam Shanechi, PhD, now at Cornell University, and Jessica Chemali, MGH Department of Anesthesia, Critical Care and Pain Medicine. Additional co-authors are Max Liberman and Ken Solt, MD, MGH Anesthesia. Primary support for this work is through an National Institutes of Health Director's Pioneer Award to Brown.

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $775 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine.


ELSE PRESS RELEASES FROM THIS DATE:

Leading cause of heart disease ignored in North America's poorest communities

2013-11-01
Leading cause of heart disease ignored in North America's poorest communities Inaction has jeopardized the health and economic well-being of millions A leading cause of heart disease remains overlooked in North America's most impoverished communities, researchers ...

NYU study on incarcerated youth shows potential to lower anti-social behavior and recidivism

2013-11-01
NYU study on incarcerated youth shows potential to lower anti-social behavior and recidivism The researchers investigated the impact of cognitive behavioral therapy and mindfulness training on attentional task performance in incarcerated adolescents Researchers ...

Microbleeds important to consider in brain-related treatments, UCI neurologist says

2013-11-01
Microbleeds important to consider in brain-related treatments, UCI neurologist says Stroke prevention strategies should address both blood clotting, protection of vessels Irvine, Calif., Oct. 31, 2013 — As growing numbers of America's baby boomers reach retirement, ...

Scientists capture most detailed picture yet of key AIDS protein

2013-11-01
Scientists capture most detailed picture yet of key AIDS protein Finding represents a scientific feat and progress towards an HIV vaccine NEW YORK (October 31, 2013) -- Collaborating scientists at The Scripps Research Institute (TSRI) and Weill Cornell ...

NIH-funded scientists reveal structure of HIV protein key to cell entry

2013-11-01
NIH-funded scientists reveal structure of HIV protein key to cell entry Finding holds promise for HIV vaccine development Using protein engineering and two different cutting-edge structural biology imaging ...

Plant production could decline as climate change affects soil nutrients

2013-11-01
Plant production could decline as climate change affects soil nutrients As drylands of the world become even drier, water will not be the only resource in short supply. Levels of nutrients in the soil will likely be affected, and their imbalance could affect ...

Supreme Court's Obamacare decision established new limits on federal authority, IU paper says

2013-11-01
Supreme Court's Obamacare decision established new limits on federal authority, IU paper says BLOOMINGTON, Ind. -- A new paper by an Indiana University professor sheds new light on the U.S. Supreme Court's rejection of legal challenges to the Affordable Care Act, which ...

Research finds severe hot flashes reduced with quick neck injection

2013-11-01
Research finds severe hot flashes reduced with quick neck injection A shot in the neck of local anesthesia may reduce hot flashes by as much as 50 percent for at least six months, a recent Northwestern Medicine® study found. "We think we are resetting the thermostat ...

Magnetic 'force field' shields giant gas cloud during collision with Milky Way

2013-11-01
Magnetic 'force field' shields giant gas cloud during collision with Milky Way Doom may be averted for the Smith Cloud, a gigantic streamer of hydrogen gas that is on a collision course with the Milky Way Galaxy. Astronomers using the National Science ...

US policy should encourage highly skilled, foreign Ph.D. students to stay, CU-led study finds

2013-11-01
US policy should encourage highly skilled, foreign Ph.D. students to stay, CU-led study finds Attracting more talented foreign students to study at U.S. universities and encouraging them to launch entrepreneurial ventures here could help "revitalize ...

LAST 30 PRESS RELEASES:

Breathable yet protective: Next-gen medical textiles with micro/nano networks

Frequency-engineered MXene supercapacitors enable efficient pulse charging in TENG–SC hybrid systems

Developed an AI-based classification system for facial pigmented lesions

Achieving 20% efficiency in halogen-free organic solar cells via isomeric additive-mediated sequential processing

New book Terraglossia reclaims language, Country and culture

The most effective diabetes drugs don't reach enough patients yet

Breast cancer risk in younger women may be influenced by hormone therapy

Strategies for staying smoke-free after rehab

Commentary questions the potential benefit of levothyroxine treatment of mild hypothyroidism during pregnancy

Study projects over 14 million preventable deaths by 2030 if USAID defunding continues

New study reveals 33% gap in transplant access for UK’s poorest children

Dysregulated epigenetic memory in early embryos offers new clues to the inheritance of polycystic ovary syndrome (PCOS)

IVF and IUI pregnancy rates remain stable across Europe, despite an increasing uptake of single embryo transfer

It takes a village: Chimpanzee babies do better when their moms have social connections

From lab to market: how renewable polymers could transform medicine

Striking increase in obesity observed among youth between 2011 and 2023

No evidence that medications trigger microscopic colitis in older adults

NYUAD researchers find link between brain growth and mental health disorders

Aging-related inflammation is not universal across human populations, new study finds

University of Oregon to create national children’s mental health center with $11 million federal grant

Rare achievement: UTA undergrad publishes research

Fact or fiction? The ADHD info dilemma

Genetic ancestry linked to risk of severe dengue

Genomes reveal the Norwegian lemming as one of the youngest mammal species

Early birds get the burn: Monash study finds early bedtimes associated with more physical activity

Groundbreaking analysis provides day-by-day insight into prehistoric plankton’s capacity for change

Southern Ocean saltier, hotter and losing ice fast as decades-long trend unexpectedly reverses

Human fishing reshaped Caribbean reef food webs, 7000-year old exposed fossilized reefs reveal

Killer whales, kind gestures: Orcas offer food to humans in the wild

Hurricane ecology research reveals critical vulnerabilities of coastal ecosystems

[Press-News.org] Automated system promises precise control of medically induced coma
Successful animal study may lead to computer-controlled general anesthesia delivery