CLOSED-LOOP BLOOD PRESSURE CONTROL BY NEURAL STIMULATION FOR CARDIAC CARE ENVIRONMENT
通过神经刺激控制心脏护理环境的闭环血压
基本信息
- 批准号:9099079
- 负责人:
- 金额:$ 44.07万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-08-05 至 2021-01-31
- 项目状态:已结题
- 来源:
- 关键词:Adverse effectsAdverse reactionsAffectAlgorithmsAlternative TherapiesAnimal ModelAntihypertensive AgentsBlood PressureBlood Pressure MonitorsBody Weight decreasedCaliberCardiacCardiac Surgery proceduresCaringChronicCritical CareDataDevice RemovalDiabetes MellitusDiseaseDoseDropsElectric StimulationElectroacupunctureElectrodesEmergency SituationEnvironmentFascicleFeedbackFrequenciesGoalsHealthHeart RateHourHypertensionHypotensionImplantInbred SHR RatsIndividualInflammationInvestigationKnowledgeLeadLong-Term EffectsLung diseasesMethodsModalityMonitorNerveOperative Surgical ProceduresOrganOrgan failurePainPatientsPerioperativePharmaceutical PreparationsPharmacologic SubstancePhysiologic pulsePolymersProceduresRattusResearchRespirationSchemeSeriesSleep Apnea SyndromesSpecific qualifier valueSpecificitySupervisionSystemTechniquesTechnologyTimeToxic effectVagus nerve structureWidthWorkWorkloadbaseblood pressure reductionblood pressure regulationdesignflexibilityhypertension controlimprovedinterestnerve supplyneural stimulationnovel strategiesnovel therapeuticsperoneal nervepressurepreventresearch studyresponsesciatic nervesuccessvagus nerve stimulation
项目摘要
DESCRIPTION (provided by applicant): Blood pressure modulation in a cardiac care environment such as in a hypertensive emergency or during a cardiac perioperative procedure mainly relies on pharmacological approaches. With significant improvements and availabilities in antihypertensive drugs, uncontrolled blood pressure (BP) can be rapidly modulated within minutes. However, appropriate dosing of these drugs is characterized by high variability in patient response and a narrow acceptable range. Additionally, it is very difficult to reverse the antihypertensive effect of drugs in the case of drug-induced hypotension and when patients suffer from unwanted side effects; thus, pharmaceuticals are administered under strict control with the supervision of a skilled practitioner. Seeking new approaches to reduce the complications of the pharmacological solution, recent studies focusing on nerve stimulation have generated widespread interest in investigating and refining nerve stimulation strategies as an alternative therapy for controlling BP. In our ongoing investigation, we have demonstrated that electrical stimulation of a single ventral fascicle of the common peroneal nerve (vCPN) can significantly reduce the BP of hypertensive rats without significantly effecting heart rate and respiration. We further notice that stimulation parameters such as intensity, number of pulses, and frequency significantly influence the magnitude of the BP reduction. Based on our promising initial results, the objective of this research is to investigate the effect of nerve stimulation parameters on BP in order to develop a closed-loop control system. Using our implantable/removable Flexible polymer microchannel electrode array (FlexµCEA), we plan to achieve sustainable BP reduction via electrical stimulation at the Sciatic nerve or its branch (CPN or vCPN). Towards this goal, we have two aims: Aim 1. Establish nerve stimulation parameters for reliably modulating BP using an animal model of hypertension. A quantitative relationship between the following stimulation parameters and BP will be established: frequency, pulse width, intensity, and various stimulation configurations. This data will provide for us the design parameters necessary for a closed-loop BP control system leading to new therapeutic modalities for hypertension control; Aim 2. Develop an adaptive closed-loop control system with real-time BP monitoring and neural stimulation to accurately modulate BP. Using Aim 1 data, a control system will be designed to apply a specified stimulation scheme to the target nerve through the FlexµCEA for maintaining a reduced BP. Based on the success of a closed-loop application of neural stimulation to elicit sustainable BP reduction, this project may realize new strategies for hypertension control with the potential to avoid systemic side effects known in drug-based therapies.
描述(由申请人提供):心脏护理环境中(例如高血压急症或心脏围手术期)的血压调节主要依赖于药理学方法,随着抗高血压药物的显着改进和可用性,可以控制血压(BP)。然而,这些药物的适当剂量的特点是患者反应的高度可变性和可接受的范围窄,此外,在这种情况下很难逆转药物的抗高血压作用。药物引起的低血压以及当患者出现不良副作用时;因此,在熟练的从业者的监督下严格控制药物的使用,以寻求新的方法来减少药物解决方案的并发症,最近针对神经刺激的研究已经产生了广泛的研究。对研究和完善神经刺激策略作为控制血压的替代疗法的兴趣在我们正在进行的研究中,我们已经证明,对腓总神经(vCPN)的单个腹侧束进行电刺激可以显着降低高血压大鼠的血压,而不会显着影响高血压大鼠的血压。我们进一步注意到,强度、脉冲数和频率等刺激参数会显着影响血压降低的程度。基于我们有希望的初步结果,本研究的目的是研究神经的影响。为了开发闭环控制系统,我们计划使用我们的植入式/可拆卸柔性聚合物微通道电极阵列(FlexμCEA)通过对坐骨神经或其分支(CPN或CPN)进行电刺激来实现血压的可持续降低。为了实现这一目标,我们有两个目标: 目标 1. 使用高血压动物模型建立可靠调节血压的神经刺激参数 将建立以下刺激参数与血压之间的定量关系:频率、脉冲宽度、强度。以及各种刺激配置,这些数据将为我们提供闭环血压控制系统所需的设计参数,从而实现高血压控制的新治疗方式;目标 2. 开发实时自适应闭环控制系统。血压监测和神经刺激可精确调节血压,基于闭环应用的成功,将设计一个控制系统,通过 FlexμCEA 对目标神经应用指定的刺激方案。通过神经刺激来引起可持续的血压降低,该项目可能会实现高血压控制的新策略,并有可能避免药物治疗中已知的全身副作用。
项目成果
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