Medically Induced Comas Controlled By Computers
By Katie Wike, contributing writer
Automation of medically induced coma process offers more precision and efficiency
Medically induced comas can be crucial in reducing brain swelling after accidents or preventing seizures. The process also 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 team from Massachusetts General Hospital (MGH) and Massachusetts Institute of Technology (MIT) say they can automate the process and advance the control of anesthesia. Their research is published on the PLOS Computational Biology site.
Emery Brown, MD, PhD, of the MGH Department of Anesthesia, Critical Care and Pain Medicine, is quoted in a press release as saying, "People have been interested for years in finding a way to control anesthesia automatically. 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."
Generally, medically induced comas are achieved through manual anesthetic infusion and constant monitoring of brain activity through an EEG. The report argues, “A more rational approach would be to implement a brain-machine interface (BMI) that monitors the EEG and adjusts the anesthetic infusion rate in real time to maintain the specified target level of burst suppression.” This would also free a staff member from constant monitoring of a patient.
Anesthesiologists have had computer-assisted technologies for many years. Despite this, no FDA-approved system exists that completely controls anesthesia administration based on continuous monitoring of a patient's brain activity.
"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."
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