Personalized anesthetic brain monitoring: Developing novel systems, sensors, and algorithms for aging, dementia, and Alzheimers disease patients

个性化麻醉大脑监测：为衰老、痴呆和阿尔茨海默病患者开发新型系统、传感器和算法

• 批准号: 10360566
• 负责人: Tuan Le Mau
• 金额: $ 121.49万
• 依托单位: PASCALL SYSTEMS, INCORPORATED
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10360566
• 关键词: Adhesives; Age; Age-Years; Aging; Algorithms; Alzheimer' s Disease; Alzheimer' s disease patient; Alzheimer' s disease related dementia; Amplifiers; Anesthesia procedures; Anesthetics; Blood Pressure; Brain; Caring; Cognition; Cognitive; Computer software; Data; Delirium; Dementia; Electrodes; Electroencephalography; Electromagnetics; General Anesthesia; Health; Heart Rate; Hour; Human; Impaired cognition; Incidence; Individual; Life; Measurement; Modernization; Monitor; Neurosciences; Noise; Operative Surgical Procedures; Patients; Performance; Phase; Physiological; Physiology; Resolution; Respiration; Risk; Safety; Science; Sedation procedure; System; Technology; Testing; Time; Unconscious State; United States; Work; age related; base; biomaterial compatibility; cytotoxicity; design; electric impedance; experience; high risk; improved; individual patient; insight; irritation; middle age; mild cognitive impairment; mortality; novel; older patient; post-operative cognitive dysfunction; postoperative delirium; product development; prototype; response; sedative; sensor; sex; signal processing; touchscreen; wearable device; wireless

PROJECT SUMMARY In the United States, nearly 100,000 patients receive general anesthesia and sedation daily to safely undergo surgical and non-surgical procedures. A high proportion of these patients are older than 65 years of age. These older patients are at higher risk of post-operative delirium and cognitive dysfunction. Many of these older patients have dementia, including mild cognitive impairment or Alzheimer’s disease, further elevating their risk of POD and POCD. Anesthesiologists are familiar with how to adjust anesthetic management to account for changes in systemic physiology in older patients, e.g., blood pressure, heart rate, or respiration. Unfortunately, with existing technologies, anesthesiologists have no physiologically principled way to account for age-dependent changes in the brain’s response to anesthetic drugs. Today’s anesthetic brain monitors were developed in the 1990’s and do not account for recently-described age-dependent changes in brain activity during anesthesia. When these now outdated monitors are used, older patients are up to 10-times more likely to receive more anesthesia than necessary to maintain unconscious. In short, currently available anesthetic brain monitors are based on outdated science and technology and predispose older patients to unnecessarily high anesthetic exposures. The consequences for older patients and patients with dementia and/or Alzheimer’s disease can be significant, since increased anesthetic exposure is associated with increased incidence of delirium, post-operative cognitive dysfunction, and even mortality. PASCALL Systems, Inc. proposes to develop novel systems and personalized algorithms to monitor aging, dementia, and Alzheimer’s disease patients during general anesthesia and sedation.

项目总结 在美国，每天有近10万名患者接受全身麻醉和镇静，以安全地接受 外科手术和非外科手术。这些患者中有很高比例的人年龄超过65岁。这些 年龄较大的患者术后精神错乱和认知功能障碍的风险更高。这些老年患者中的许多人 患有痴呆症，包括轻度认知障碍或阿尔茨海默病，进一步增加了他们患POD的风险 和POCD。麻醉师熟悉如何调整麻醉管理以适应 老年患者的全身生理学，例如血压、心率或呼吸。不幸的是，在现有的 技术，麻醉师没有生理原则性的方法来解释年龄相关的变化 大脑对麻醉药的反应。今天的麻醉性脑监测器是在20世纪90年代发展起来的S 并且没有解释最近描述的麻醉期间大脑活动随年龄的变化。什么时候 现在使用这些过时的监护仪，年龄较大的患者接受更多麻醉的可能性高达10倍 而不是维持无意识所必需的。简而言之，目前可用的麻醉性脑监测器是基于 过时的科学和技术，使老年患者容易受到不必要的高麻醉剂暴露。 对老年患者以及痴呆症和/或阿尔茨海默病患者的影响可能是显著的， 由于麻醉剂暴露的增加与精神错乱的发生率增加有关，因此术后认知 功能障碍，甚至死亡。Pascall Systems，Inc.建议开发新的系统和个性化 在全身麻醉和镇静期间监测衰老、痴呆症和阿尔茨海默病患者的算法。