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Automated system promises precise control of medically induced coma
Date:10/31/2013

ted technologies for many years, no FDA-approved system exists that completely controls anesthesia administration based on continuous monitoring of a patient's brain activity. Until the current study, Brown notes, no one had demonstrated the level of control required for a completely automated system. Keeping patients at a precise level of brain activity for several days, as required for medically induced coma, appeared to be both a feasible goal and one that cried out for the sort of computer-controlled system called a brain-machine interface.

Adapting programs they had previously developed to analyze the activity of neurons, Brown's team developed algorithms to read and analyze an EEG pattern in real time and determine a target level of brain activity in this case the stage of burst suppression. Based on that target, an automated control device adjusts the flow of an anesthetic drug to achieve the desired brain state, and real-time analysis of the continuous EEG readings is fed back to the system to insure maintenance of the target. When the researchers tested their system in a rodent model, the actual EEG-based measure of burst suppression tracked the target trajectory almost exactly.

"As far as we know, these are the best results for automated control of anesthesia that have ever been published," says Brown, who is the Warren M. Zapol Professor of Anesthesia at Harvard Medical School and the Edward Hood Taplin Professor of Medical Engineering and Computational Neuroscience at MIT. "We're now in discussions with the FDA for approval to start testing this in patients." The MGH has also applied for a patent for the technology.

Among the benefits of such a system, Brown explains, would be the ability to maintain medical coma at a more precise, consistent level than can be done manually and using lower doses of anesthetic drugs, a reduction that is possible with any computer-assisted technology. Eliminating the need to devote o
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Source:Eurekalert

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