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:

From octopus intelligence to smart artificial blood vessels: 2025 Schmidt Science Fellows to break new ground with interdisciplinary research

Experts challenge aspirin guidelines based on their undue reliance on a flawed trial

McGill discovery sheds new light on autism, intellectual disabilities

Cellular changes occur even below the hexavalent chromium limit

Study suggests a new way to curb social media’s body image toll

Plant doctor: An AI system that watches over urban trees without touching a leaf

Study tracks chromium chemistry in irradiated molten salts

Scientists: the beautiful game is a silver bullet for global health

Being physically active, even just a couple of days a week, may be key to better health

High-fat diet promote breast cancer metastasis in animal models

A router for photons

Nurses and AI collaborate to save lives, reduce hospital stays

Multi-resistance in bacteria predicted by AI model

Tinker Tots: A citizen science project to explore ethical dilemmas in embryo selection

Sensing sickness

Cost to build multifamily housing in California more than twice as high as in Texas

Program takes aim at drinking, unsafe sex, and sexual assault on college campuses

Inability to pay for healthcare reaches record high in U.S.

Science ‘storytelling’ urgently needed amid climate and biodiversity crisis

KAIST Develops Retinal Therapy to Restore Lost Vision​

Adipocyte-hepatocyte signaling mechanism uncovered in endoplasmic reticulum stress response

Mammals were adapting from life in the trees to living on the ground before dinosaur-killing asteroid

Low LDL cholesterol levels linked to reduced risk of dementia

Thickening of the eye’s retina associated with greater risk and severity of postoperative delirium in older patients

Almost one in ten people surveyed report having been harmed by the NHS in the last three years

Enhancing light control with complex frequency excitations

New research finds novel drug target for acute myeloid leukemia, bringing hope for cancer patients

New insight into factors associated with a common disease among dogs and humans

Illuminating single atoms for sustainable propylene production

New study finds Rocky Mountain snow contamination

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