Intraoperative Brain Dysfunction Monitor/Detector

描述（由申请人提供）：在这个项目中，我们建议开发一种先进的术中监护仪NeuroGUARD，用于早期检测脑功能障碍和缺血。这种监测器在心血管手术中特别有用，因为这些手术特别容易引起术中和术后脑损伤。手术团队面临的主要困难之一是潜在的血液流向大脑的中断，例如，接下来的主动脉或颈动脉夹紧。这可能导致脑缺血，即大脑氧合水平的严重下降，严重影响神经系统预后（认知障碍、癫痫发作、运动/语言/视觉功能丧失，最终死亡）。

DESCRIPTION (provided by applicant): In this program, we propose to develop an advanced intra-operative monitor, the NeuroGUARD, for the early detection of brain dysfunction and ischemia. This monitor will be particularly useful during cardiovascular surgeries since these procedures are specially prone to inducing intra- and post-operative brain injury. One of the major difficulties that surgical team faces is the potential interruption of blood flow to the brain for example, the following aortic or carotid clamping. This can result in brain ischemia, a critical drop in the oxygenation level in the brain, which seriously affects the neurologic outcome (cognitive impairment, seizures, loss of motor/speech/vision functions, and ultimately, death). Our proposed intra-operative brain dysfunction monitor/detector will quantify and analyze cortical activity of the surgical patient through real-time analysis of EEG acquired from multiple scalp locations. The proposed system will utilize state-of-the-art technology developed by Cleveland Medical Devices Inc. (CleveMED), for neurophysiologic data acquisition in electrically hostile environments such as the Operating Room (OR). This intra-operative neuromonitoring hardware will be integrated with an enhanced mutli-channel version of a novel wavelet-based algorithm - WAV, which was developed by the PI for quantitative depth of anesthesia monitoring based on a single frontal EEG channel. The multi-channel cortical activity indexes (M-WAVs) to be developed in this program will represent a real-time assessment of the global brain state. In addition, the M-WAV indexes will be compiled into a warning algorithm module, which will signal an alarm based on predetermined patterns of cortical activity indicative of local/global brain dysfunction. In order to ensure that the clinical community endorses the NeuroGUARD, the proposed system will undergo an extensive clinical evaluation using data from two medical centers during two high-risk cardiovascular procedures - Coronary Artery Bypass Graft (CABG) and Carotide Entarterectomy (CEA).