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

项目摘要 在美国，每天有近10万患者接受全身麻醉和镇静以安全接受手术 外科和非外科手术。这些患者中有很大一部分年龄超过65岁。这些 老年患者术后谵妄和认知功能障碍的风险较高。许多老年患者 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 还有POCD麻醉师熟悉如何调整麻醉管理，以应对 老年患者的全身生理学，例如，血压心率或呼吸不幸的是，随着现有 技术，麻醉师没有生理学原则的方法来解释年龄依赖性变化 大脑对麻醉药物的反应今天的麻醉脑监测器是在20世纪90年代开发的 并且不能解释最近描述的麻醉期间脑活动的年龄依赖性变化。当 使用这些过时的监护仪，老年患者接受更多麻醉的可能性高达10倍 比保持无意识所需的要多。简而言之，目前可用的麻醉脑监测器是基于 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后果可能很严重， 由于麻醉剂暴露增加与谵妄发生率增加相关，因此术后认知功能障碍 功能障碍甚至死亡PASCALL Systems，Inc.建议开发新的系统和个性化的 在全身麻醉和镇静期间监测衰老、痴呆和阿尔茨海默病患者的算法。

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 When these now outdated monitors are used, older patients are up to 10-times more likely to receive more anesthesia than necessary to maintain unconscious. In short, currently available anesthetic brain monitors are based on outdated science and technology and predispose older patients to unnecessarily high anesthetic exposures.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.