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基于脑电图记录的准确机器学习麻醉深度监测

Accurate Machine Learning-based Monitoring of Anesthesia Depth with EEG Recording.

作者信息

Tu Zhiyi, Zhang Yuehan, Lv Xueyang, Wang Yanyan, Zhang Tingting, Wang Juan, Yu Xinren, Chen Pei, Pang Suocheng, Li Shengtian, Yu Xiongjie, Zhao Xuan

机构信息

Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.

Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai, 200240, China.

出版信息

Neurosci Bull. 2025 Mar;41(3):449-460. doi: 10.1007/s12264-024-01297-w. Epub 2024 Sep 17.

DOI:10.1007/s12264-024-01297-w
PMID:39289330
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11876477/
Abstract

General anesthesia, pivotal for surgical procedures, requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments. Traditional assessment methods, relying on physiological indicators or behavioral responses, fall short of accurately capturing the nuanced states of unconsciousness. This study introduces a machine learning-based approach to decode anesthesia depth, leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats. Our findings demonstrate the model's robust predictive accuracy, underscored by a novel intra-subject dataset partitioning and a 5-fold cross-validation method. The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states, highlighting distinct EEG patterns and enhancing prediction accuracy. Moreover, the model's ability to generalize across individuals suggests its potential for broad clinical application, distinguishing between anesthetic agents and their depths. Despite relying on rat EEG data, which poses questions about real-world applicability, our approach marks a significant advance in anesthesia monitoring.

摘要

全身麻醉是外科手术的关键,需要精确的深度监测以降低从术中知晓到术后认知障碍等一系列风险。传统的评估方法依赖生理指标或行为反应,无法准确捕捉细微的意识状态。本研究引入了一种基于机器学习的方法来解码麻醉深度,利用大鼠在丙泊酚和艾司氯胺酮诱导的不同麻醉状态下的脑电图(EEG)数据。我们的研究结果通过一种新颖的受试者内数据集划分和五折交叉验证方法,证明了该模型具有强大的预测准确性。该研究与传统监测方法不同,它利用麻醉输注速率作为麻醉状态的客观指标,突出了不同的脑电图模式并提高了预测准确性。此外,该模型在个体间的泛化能力表明其具有广泛临床应用的潜力,能够区分麻醉药物及其深度。尽管该研究依赖大鼠脑电图数据,这对其在现实世界中的适用性提出了疑问,但我们的方法标志着麻醉监测领域的重大进展。

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本文引用的文献

1
Depth of Anesthesia and Nociception Monitoring: Current State and Vision For 2050.麻醉深度和伤害感受监测:现状与 2050 年展望。
Anesth Analg. 2024 Feb 1;138(2):295-307. doi: 10.1213/ANE.0000000000006860. Epub 2024 Jan 12.
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Effect of remimazolam on electroencephalogram burst suppression in elderly patients undergoing cardiac surgery: Protocol for a randomized controlled noninferiority trial.瑞米唑仑对老年心脏手术患者脑电图爆发抑制的影响:一项随机对照非劣效性试验方案
Heliyon. 2023 Dec 18;10(1):e23879. doi: 10.1016/j.heliyon.2023.e23879. eCollection 2024 Jan 15.
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Association between cumulative duration of deep anesthesia and postoperative acute kidney injury after noncardiac surgeries: a retrospective observational study.非心脏手术后累积深度麻醉时间与术后急性肾损伤的关系:一项回顾性观察研究。
Ren Fail. 2023;45(2):2287130. doi: 10.1080/0886022X.2023.2287130. Epub 2023 Nov 29.
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Propofol modulates neural dynamics of thalamo-cortical system associated with anesthetic levels in rats.丙泊酚调节大鼠中与麻醉水平相关的丘脑-皮质系统的神经动力学。
Cogn Neurodyn. 2023 Dec;17(6):1541-1559. doi: 10.1007/s11571-022-09912-0. Epub 2022 Nov 22.
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Prefrontal cortex as a key node in arousal circuitry.前额皮质作为觉醒回路的关键节点。
Trends Neurosci. 2022 Oct;45(10):722-732. doi: 10.1016/j.tins.2022.07.002. Epub 2022 Aug 19.
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Cross-Modal Interaction and Integration Through Stimulus-Specific Adaptation in the Thalamic Reticular Nucleus of Rats.通过大鼠丘脑网状核的刺激特异性适应进行跨模态交互和整合。
Neurosci Bull. 2022 Jul;38(7):785-795. doi: 10.1007/s12264-022-00827-8. Epub 2022 Feb 25.
7
Differential Alterations to the Metabolic Connectivity of the Cortical and Subcortical Regions in Rat Brain During Ketamine-Induced Unconsciousness.氯胺酮诱导意识丧失大鼠脑皮质和皮质下区域代谢连接的差异变化。
Anesth Analg. 2022 Nov 1;135(5):1106-1114. doi: 10.1213/ANE.0000000000005869. Epub 2022 Jan 10.
8
Anaesthetic depth and delirium after major surgery: a randomised clinical trial.全麻深度与大手术后谵妄:一项随机临床试验
Br J Anaesth. 2021 Nov;127(5):704-712. doi: 10.1016/j.bja.2021.07.021. Epub 2021 Aug 28.
9
The role of PFC networks in cognitive control and executive function.前额叶皮质网络在认知控制和执行功能中的作用。
Neuropsychopharmacology. 2022 Jan;47(1):90-103. doi: 10.1038/s41386-021-01152-w. Epub 2021 Aug 18.
10
Granger Causality of the Electroencephalogram Reveals Abrupt Global Loss of Cortical Information Flow during Propofol-induced Loss of Responsiveness.脑电信号的格兰杰因果关系揭示了异丙酚诱导意识消失过程中皮质信息传递的突然全局丧失。
Anesthesiology. 2020 Oct 1;133(4):774-786. doi: 10.1097/ALN.0000000000003398.