Emulation of the BIS engine.

Emulation of the BIS engine.
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DOI:
10.1007/s10877-021-00676-2
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发表时间:
2022-04
影响因子:
2.2
通讯作者:
Connor CW
Connor CW
中科院分区:
医学3区
文献类型:
--
作者:
Connor CW

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尽管已有 20 年的临床使用经验和 3000 篇学术文章,但 BIS 监护仪的操作仍未被描述。可以使用原始设计者留下的调试接口通过取证反汇编从 A-2000 显示器的主板上以二进制形式检索核心算法软件(BIS 引擎),从而开启了通过仿真在当代计算机上执行 BIS 算法的可能性。仿真需要三个步骤。首先,拆卸监视器输入级监视器,以确定如何将 EEG 信号兼容地呈现给引擎。其次,在软件中重新创建了引擎执行的数字信号处理器。第三,对引擎代码进行了修补,允许与监视器硬件分离执行。评估了噪声负载下的代码性能。使用现代 BIS 监测仪从正常生理睡眠中的 13 岁儿童获得 EEG 信号和 BIS 变量。睡眠儿童的 BIS 值表现出广泛的动态范围,包括名义上与临床麻醉相关的值,提供了一种无风险的技术来获取广泛运用算法的经验脑电图数据。仿真显示相关系数为 R=0.943,与官方 Engine 迭代之间的相关性一致。 EEG 中的附加白噪声导致 BIS 值逐渐升高和变平。仿真复制 BIS 引擎行为,允许根据现有 EEG 数据集或来自其他可能远程或无线设备的信号进行计算。仿真为阐明算法的数学表达式提供了优势,这对于任何假设的麻醉剂作用机制的实际约束仍然很重要。
The operation of the BIS monitor remains undescribed, despite 20 years of clinical use and 3000 academic articles. The core algorithmic software (the BIS Engine) can be retrieved from the motherboard of the A-2000 monitor in binary form through forensic disassembly using debugging interfaces left in place by the original designers, opening the possibility of executing the BIS algorithms on contemporary computers through emulation. Three steps were required for emulation. Firstly, the monitor input stage monitor was disassembled to determine how EEG signals can be compatibly presented to the Engine. Secondly, the Digital Signal Processor on which the Engine executes was recreated in software. Thirdly, the Engine code was patched, allowing execution separated from monitor hardware. Code performance under noise load was evaluated. EEG signals and BIS variables were obtained from a 13-year-old child in normal physiological sleep using a modern BIS monitor. BIS values in sleeping children exhibit a wide dynamic range, including values nominally associated with clinical anesthesia, providing a risk-free technique to obtain empirical EEG data that broadly exercise the algorithms. Emulation demonstrated a correlation coefficient of R=0.943, consistent with correlations between official Engine iterations. Additive white noise in the EEG caused a progressive lifting and flattening of BIS values. Emulation replicates BIS Engine behavior, allowing calculation upon existing EEG datasets or signals from other, potentially remote or wireless, devices. Emulation provides advantages for elucidating the mathematical expression of the algorithms, which remain important as practical constraints on any hypothetical mechanism of action of anesthetics.
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