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

A new way to monitor induced comas

Automated system could offer better control of patients' brain states

2013-11-01
(Press-News.org) Contact information: Andrew Carleen
acarleen@mit.edu
617-253-1682
Massachusetts Institute of Technology
A new way to monitor induced comas Automated system could offer better control of patients' brain states CAMBRIDGE, Mass-- After suffering a traumatic brain injury, patients are often placed in a coma to give the brain time to heal and allow dangerous swelling to dissipate. These comas, which are induced with anesthesia drugs, can last for days. During that time, nurses must closely monitor patients to make sure their brains are at the right level of sedation — a process that MIT's Emery Brown describes as "totally inefficient."

"Someone has to be constantly coming back and checking on the patient, so that you can hold the brain in a fixed state. Why not build a controller to do that?" says Brown, the Edward Hood Taplin Professor of Medical Engineering in MIT's Institute for Medical Engineering and Science, who is also an anesthesiologist at Massachusetts General Hospital (MGH) and a professor of health sciences and technology at MIT.

Brown and colleagues at MGH have now developed a computerized system that can track patients' brain activity and automatically adjust drug dosages to maintain the correct state. They have tested the system — which could also help patients who suffer from severe epileptic seizures — in rats and are now planning to begin human trials.

Maryam Shanechi, a former MIT grad student who is now an assistant professor at Cornell University, is the lead author of the paper describing the computerized system in the XXX issue of the journal PLOS Computational Biology.

Tracking the brain

Brown and his colleagues have previously analyzed the electrical waves produced by the brain in different states of activity. Each state — awake, asleep, sedated, anesthetized and so on — has a distinctive electroencephalogram (EEG) pattern.

When patients are in a medically induced coma, the brain is quiet for up to several seconds at a time, punctuated by short bursts of activity. This pattern, known as burst suppression, allows the brain to conserve vital energy during times of trauma.

As a patient enters an induced coma, the doctor or nurse controlling the infusion of anesthesia drugs tries to aim for a particular number of "bursts per screen" as the EEG pattern streams across the monitor. This pattern has to be maintained for hours or days at a time.

"If ever there were a time to try to build an autopilot, this is the perfect time," says Brown, who is a professor in MIT's Department of Brain and Cognitive Sciences. "Imagine that you're going to fly for two days and I'm going to give you a very specific course to maintain over long periods of time, but I still want you to keep your hand on the stick to fly the plane. It just wouldn't make sense."

To achieve automated control, Brown and colleagues built a brain-machine interface — a direct communication pathway between the brain and an external device that typically assists human cognitive, sensory or motor functions. In this case, the device — an EEG system, a drug-infusion pump, a computer and a control algorithm — uses the anesthesia drug propofol to maintain the brain at a target level of burst suppression.

The system is a feedback loop that adjusts the drug dosage in real time based on EEG burst-suppression patterns. The control algorithm interprets the rat's EEG, calculates how much drug is in the brain, and adjusts the amount of propofol infused into the animal second-by-second.

The controller can increase the depth of a coma almost instantaneously, which would be impossible for a human to do accurately by hand. The system could also be programmed to bring a patient out of an induced coma periodically so doctors could perform neurological tests, Brown says.

This type of system could take much of the guesswork out of patient care, says Sydney Cash, an associate professor of neurology at Harvard Medical School.

"Much of what we do in medicine is making educated guesses as to what's best for the patient at any given time," says Cash, who was not part of the research team. "This approach introduces a methodology where doctors and nurses don't need to guess, but can rely on a computer to figure out — in much more detail and in a time-efficient fashion — how much drug to give."

Monitoring anesthesia

Brown believes that this approach could easily be extended to control other brain states, including general anesthesia, because each level of brain activity has its own distinctive EEG signature.

"If you can quantitatively analyze each state's signature in real time and you have some notion of how the drug moves through the brain to generate those states, then you can build a controller," he says.

There are currently no devices approved by the U.S. Food and Drug Administration (FDA) to control general anesthesia or induced coma, but there is a device available in Europe and South America, based on an algorithm that uses the patient's EEG to compute an index on a 100-point scale. However, that system keeps the patient's brain activity within a very wide range and does not allow for precise control, Brown says.

The MIT and MGH researchers are now preparing applications to the FDA to test the controller in humans.

###

The research was funded by the National Institutes of Health through a Pioneer Award and a Transformative Research Award.

END



ELSE PRESS RELEASES FROM THIS DATE:

Critical gene in retinal development and motion sensing identified

2013-11-01
Critical gene in retinal development and motion sensing identified Discovery aids in understanding the organization of parts of the eye, brain Our vision depends on exquisitely organized layers of cells within the eye's retina, each with a distinct role in perception. ...

Gene found to foster synapse formation in the brain

2013-11-01
Gene found to foster synapse formation in the brain Implications for language development, autism, epilepsy Researchers at Johns Hopkins say they have found that a gene already implicated in human speech disorders and epilepsy is also needed for vocalizations and ...

Pregnant women who snore at higher risk for C-sections, delivering smaller babies

2013-11-01
Pregnant women who snore at higher risk for C-sections, delivering smaller babies Snoring at least 3 nights a week may influence delivery and baby's health; higher risk for moms with sleep-related breathing problem pre-pregnancy ANN ARBOR, Mich. — ...

'Flipping the switch' reveals new compounds with antibiotic potential

2013-11-01
'Flipping the switch' reveals new compounds with antibiotic potential CORVALLIS, Ore. – Researchers at Oregon State University have discovered that one gene in a common fungus acts as a master regulator, and deleting it has opened access to a wealth ...

Former missile-tracking telescope helps reveal fate of baby pulsar

2013-11-01
Former missile-tracking telescope helps reveal fate of baby pulsar A radio telescope once used to track ballistic missiles has helped astronomers determine how the magnetic field structure and rotation of the young and rapidly rotating Crab pulsar ...

Automated system promises precise control of medically induced coma

2013-11-01
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 ...

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 ...

LAST 30 PRESS RELEASES:

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

Study examines lactation in critically ill patients

UVA Engineering Dean Jennifer West earns AIMBE’s 2025 Pierre Galletti Award

Doubling down on metasurfaces

New Cedars-Sinai study shows how specialized diet can improve gut disorders

Making moves and hitting the breaks: Owl journeys surprise researchers in western Montana

PKU Scientists simulate the origin and evolution of the North Atlantic Oscillation

ICRAFT breakthrough: Unlocking A20’s dual role in cancer immunotherapy

How VR technology is changing the game for Alzheimer’s disease

A borrowed bacterial gene allowed some marine diatoms to live on a seaweed diet

Balance between two competing nerve proteins deters symptoms of autism in mice

Use of antifungals in agriculture may increase resistance in an infectious yeast

Awareness grows of cancer risk from alcohol consumption, survey finds

The experts that can outsmart optical illusions

Pregnancy may reduce long COVID risk

Scientists uncover novel immune mechanism in wheat tandem kinase

Three University of Virginia Engineering faculty elected as AAAS Fellows

[Press-News.org] A new way to monitor induced comas
Automated system could offer better control of patients' brain states