Putting patients with severe head injuries or persistent seizures into a medically induced coma currently requires that a nurse or other health professional constantly monitor the patient's brain activity and manually adjust drug infusion to maintain a deep state of anesthesia. Now a computer-controlled system developed by Massachusetts General Hospital (MGH) investigators promises to automate the process, making it more precise and efficient and opening the door to more advanced control of anesthesia. The team, including colleagues from Massachusetts Institute of Technology (MIT), reports successfully testing their approach in animals in the open access journal PLOS Computational Biology.
"People have been interested for years in finding a way to control anesthesia automatically," says Emery Brown, MD, PhD, of the MGH Department of Anesthesia, Critical Care and Pain Medicine, senior author of the report. "To use an analogy that compares giving anesthesia to flying a plane, the way it's been done is like flying a direct course for hours or even days without using an autopilot. This is really something that we should have a computer doing."
As part of a long-term project investigating the physiological basis of general anesthesia, Brown's team at MGH and MIT has identified and studied patterns of brain activity reflecting various states of anesthesia. One of the deepest states called burst suppression is characterized by an electroencephalogram (EEG) pattern in which brief periods of brain activity the bursts are interrupted by stretches of greatly reduced activity that can last for seconds or longer. When patients with serious head injuries that cause a buildup of pressure within the skull or those with persistent seizures are put into a medically induced coma to protect against additional damage, the goal is to maintain brain activity in a state of burst suppression.
Although anesthesiologists have had computer-assis
|Contact: Sue McGreevey|
Massachusetts General Hospital