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Instantaneous monitoring of heart beat dynamics during anesthesia and sedation

Valenza, G and Akeju, O and Pavone, KJ and Citi, L and Hartnack, KE and Sampson, A and Purdon, PL and Brown, EN and Barbieri, R (2014) 'Instantaneous monitoring of heart beat dynamics during anesthesia and sedation.' Journal of Computational Surgery, 3 (1). 1 - 18. ISSN 2194-3990

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Abstract

Anesthesia-induced altered arousal depends on drugs having their effect in specific brain regions. These effects are also reflected in autonomic nervous system (ANS) outflow dynamics. To this extent, instantaneous monitoring of ANS outflow, based on neurophysiological and computational modeling, may provide a more accurate assessment of the action of anesthetic agents on the cardiovascular system. This will aid anesthesia care providers in maintaining homeostatic equilibrium and help to minimize drug administration while maintaining antinociceptive effects. In previous studies, we established a point process paradigm for analyzing heartbeat dynamics and have successfully applied these methods to a wide range of cardiovascular data and protocols. We recently devised a novel instantaneous nonlinear assessment of ANS outflow, also suitable and effective for real-time monitoring of the fast hemodynamic and autonomic effects during induction and emergence from anesthesia. Our goal is to demonstrate that our framework is suitable for instantaneous monitoring of the ANS response during administration of a broad range of anesthetic drugs. Specifically, we compare the hemodynamic and autonomic effects in study participants undergoing propofol (PROP) and dexmedetomidine (DMED) administration. Our methods provide an instantaneous characterization of autonomic state at different stages of sedation and anesthesia by tracking autonomic dynamics at very high time-resolution. Our results suggest that refined methods for analyzing linear and nonlinear heartbeat dynamics during administration of specific anesthetic drugs are able to overcome nonstationary limitations as well as reducing inter-subject variability, thus providing a potential real-time monitoring approach for patients receiving anesthesia.

Item Type: Article
Uncontrolled Keywords: Autonomic nervous system; Electrocardiogram; Electroencephalogram; Heart rate variability; Respiratory sinus arrhythmia; Anesthesia; Sedation; Propofol; Dexmedetomidine; Instantaneous point process monitoring
Subjects: T Technology > TK Electrical engineering. Electronics Nuclear engineering
Divisions: Faculty of Science and Health > Computer Science and Electronic Engineering, School of
Depositing User: Luca Citi
Date Deposited: 23 Jan 2015 13:03
Last Modified: 17 Aug 2017 17:41
URI: http://repository.essex.ac.uk/id/eprint/12340

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