Neurological brain damage is observed not only in patients with severe traumatic brain injury, but also in patients who underwent cardiac surgery or even in patients with eye disease. Cerebrovascular autoregulation (CA) is one of the essential physiological factors whose impairments affect the poor outcome of neurosurgical (brain trauma, hemorrhagic strokes, etc.) or cardiac surgery patients, but are also associated with neurodegenerative phenomena that cause glaucoma.
Many patients undergoing cardiac surgery with cardiopulmonary bypass have post-operative cognitive deterioration due to CA impairments during surgery. Neurological postoperative complications such as cognitive dysfunction and delirium are observed in approximately 53-83% of cardiac surgery patients after discharge from hospital and up to 42% of patients even 5 years after the surgery. Treatment for post-traumatic and post-operative (neurosurgical, cardiac surgery, organ transplantation) neurological brain injuries costs billions of US dollars worldwide. To solve this problem, a brain neuroprotection competence center will be developed, which will consist of a team of scientists and doctors from Kaunas University of Technology, Lithuanian University of Health Sciences and Vilnius University Hospital Santaros Klinikos.
The aim of the project is to develop an innovative patentable product – neuroprotective system for real-time physiological brain function monitoring and prevention of cognitive deterioration as well as to perform R&D and clinical validation of the system. A prospective scientific clinical study will be conducted to perform real-time interventional medical procedures to prevent excessive CA impairments and reduce the risk of brain damage in neurosurgical and cardiac surgery patients.
Project funding:
This research project is funded by the European Regional Development Fund according to the 2014–2020 Operational Programme for the European Union Funds’ Investments under measure No. 01.2.2-CPVA-K-703 “Strengthening of Activities of Competence Centres’ and Innovation and Technology Transfer Centers’ “.
Project results:
Neurological disorders of the cognitive functions of the brain after cardiosurgical operations with artificial blood circulation are observed in about 35-83 percent of patients. Cerebral blood flow autoregulation (SKAR) impairments during surgery are one of the controllable factors associated with postoperative complications. In order to reduce the percentage of post-operative cognitive function impairments, it is necessary to propose and develop innovative technologies for detecting the onset of SKAR and personalized precise disruption of cerebral blood flow autoregulation and its termination within a few minutes, because brain neurons are damaged and die within 4-5 minutes after the onset of SKAR impairment. To solve this problem, a brain neuroprotection competence center was created, which consists of a team of scientists and doctors from Kaunas University of Technology, Lithuanian University of Health Sciences and Vilnius University Santaras Clinics. The project proposed and developed an innovative system for real-time physiological monitoring of the brain and prevention of cognitive function disorders, and R&D and clinical validation of this system are being carried out. The proposed technological solution is already being patented – two US and two EU patent applications have been registered in 2022-2023. A prospective scientific clinical study was carried out. It was possible to collect the real-time monitoring data of SKAR of 119 cardiac surgery patients. A record time resolution for identification of the start of SKAR disruption was achieved. It has been shown that a single patient-specific SKAR disruption event, the duration of which exceeds the individual patient’s critical allowable duration value, is statistically significant associated with postoperative cognitive deficit and dysfunction. In the studied patient population, this critical duration of the longest SKAR impairment is 3.7 min, which supports the findings of our previous studies. An innovative product developed and clinically validated in the project is a neuroprotective system that enables the transformation of the Heart and Lung Machine from a device that damages the patient’s brain into a device that protects the brain. This is a global innovation in the market of medical devices.
Period of project implementation: 2020-04-24 - 2023-08-31
Project coordinator: Kaunas University of Technology
Project partners: Lithuanian University of Health Sciences, Vilnius University Hospital Santaros klinikos
