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Automating Anesthesia For Medically Induced Comas

Using a computer to precisely control medically induced comas could mean gains for patient safety and hospital staffing

2 min read
Automating Anesthesia For Medically Induced Comas

In some scenarios it can be safer for health professionals to put certain patients, those with persistent seizures or brain trauma for example, into medically induced comas during treatment or recovery. But this requires full time supervision from hospital staff because the process involves watching a patient's EEG and manually adjusting the anesthesia drugs to keep brain activity stable. But a new system tested in animals and published in PLOS Computational Biology yesterday automates the monitoring and dosage modification.

The team, which includes scientists from Massachusetts General Hospital (MGH) and Massachusetts Institute of Technology (MIT), modified some of its existing software which measures brain activity, and integrated algorithms to evaluate EEG patterns, set goals for appropriate brain activity, and control devices that administer anesthesia, all in real time. The group tested the their closed loop control in a rodent model and found that the system's EEG measurements were almost perfect.

In a press release, Emery Brown, an anesthesiologist and the senior author on the paper noted that, "As far as we know, these are the best results for automated control of anesthesia that have ever been published. We're now in discussions with the FDA for approval to start testing this in patients.

Anesthesiologists currently work with some computer assistance, but the FDA hasn't yet approved a fully automated system for monitoring patients' brain activity and modulating their anesthesia doses appropriately. This research is important because it is some of the first, if not the very first, to show both aspects functioning at once in real time with a safe level of precision and control. Since medically induced comas require keeping patients at the correct level of brain activity for hours or often days, a system that is totally controlled by a computer would reduce the manpower needed in Intensive Care Units and could even hold patients' brain activity stable with lower doses of anesthesia.

Photo: iStockphoto

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This Implant Turns Brain Waves Into Words

A brain-computer interface deciphers commands intended for the vocal tract

10 min read
A man using an interface, looking at a screen with words on it.

A paralyzed man who hasn’t spoken in 15 years uses a brain-computer interface that decodes his intended speech, one word at a time.

University of California, San Francisco

A computer screen shows the question “Would you like some water?” Underneath, three dots blink, followed by words that appear, one at a time: “No I am not thirsty.”

It was brain activity that made those words materialize—the brain of a man who has not spoken for more than 15 years, ever since a stroke damaged the connection between his brain and the rest of his body, leaving him mostly paralyzed. He has used many other technologies to communicate; most recently, he used a pointer attached to his baseball cap to tap out words on a touchscreen, a method that was effective but slow. He volunteered for my research group’s clinical trial at the University of California, San Francisco in hopes of pioneering a faster method. So far, he has used the brain-to-text system only during research sessions, but he wants to help develop the technology into something that people like himself could use in their everyday lives.

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