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: 9909360
• 负责人: Tuan Le Mau
• 金额: $ 44.97万
• 依托单位: PASCALL SYSTEMS, INCORPORATED
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9909360
• 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; Wireless Technology; 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

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.

项目概要 在美国，每天有近 100,000 名患者接受全身麻醉和镇静以安全接受手术 这些患者中很大一部分年龄超过 65 岁。 老年患者术后谵妄和认知功能障碍的风险较高。 患有痴呆症，包括轻度认知障碍或阿尔茨海默氏病，这进一步增加了他们患 POD 的风险 和 POCD 熟悉如何调整麻醉管理以适应变化。 不幸的是，老年患者的全身生理学，例如血压、心率或呼吸。 由于技术的发展，麻醉医师没有生理学原理的方法来解释年龄相关的变化 当今的麻醉脑监测仪是在 20 世纪 90 年代开发的。 并且没有考虑最近描述的麻醉期间大脑活动的年龄依赖性变化。 使用这些现已过时的监护仪，老年患者接受更多麻醉的可能性高出 10 倍 简而言之，目前可用的麻醉脑监视器基于。 过时的科学技术使老年患者容易遭受不必要的高麻醉暴露。 对于老年患者以及患有痴呆症和/或阿尔茨海默病的患者来说，后果可能是严重的， 由于麻醉剂暴露增加与谵妄发生率增加相关，术后认知 PASCALL Systems, Inc. 提议开发新颖的系统和个性化系统。 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。