title: Instantaneous assessment of autonomic cardiovascular control during general anesthesia.
abstract: We present a comprehensive probabilistic point process framework to estimate and monitor the instantaneous heartbeat dynamics as related to specific cardiovascular control mechanisms and hemodynamics. Assessment of the model's statistics is established through the Wiener-Volterra theory and a multivariate autoregressive (AR) structure. A variety of instantaneous cardiovascular metrics, such as heart rate (HR), heart rate variability (HRV), respiratory sinus arrhythmia (RSA), and baroreceptor-cardiac reflex (BRS), can be rigorously derived within a parametric framework and instantaneously updated with an adaptive algorithm. Instantaneous metrics of nonlinearity, such as the bispectrum of heartbeat intervals, can also be derived. We have applied the proposed point process framework to experimental recordings from healthy subjects in order to monitor cardiovascular regulation under propofol anesthesia. Results reveal interesting dynamic trends across different pharmacological interventions, confirming the ability of the algorithm to track important changes in cardiorespiratory elicited interactions, and pointing at our mathematical approach as a promising monitoring tool for an accurate, noninvasive assessment of general anesthesia.
authors.affiliation: Neuroscience Statistics Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Chen
authors.forename: Luca
authors.initials: L
authors.lastname: Citi
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Purdon
authors.forename: Emery N
authors.initials: EN
authors.lastname: Brown
authors.forename: Riccardo
authors.initials: R
authors.lastname: Barbieri
mesh_terms: D000768:Anesthesia, General; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000502:physiology*; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008955:Models, Cardiovascular; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D015742:Propofol