Abstract
The potential of Brain Computer Interfaces (BCIs) to translate brain activity into commands to control external devices during mechanical ventilation (MV) remains largely unexplored. This is surprising since the amount of patients that might benefit from such assistance is considerably larger than the number of patients requiring BCI for motor control. Given the transient nature of MV (i.e., used mainly over night or during acute clinical conditions), precluding the use of invasive methods, and inspired by current research on BCIs, we argue that scalp recorded EEG (electroencephalography) signals can provide a non-invasive direct communication pathway between the brain and the ventilator. In this paper we propose a Patient Ventilator Interface (PVI) to control a ventilator during variable conscious states (i.e., wake, sleep, etc.). After a brief introduction on the neural control of breathing and the clinical conditions requiring the use of MV we discuss the conventional techniques used during MV. The schema of the PVI is presented followed by a description of the neural signals that can be used for the on-line control. To illustrate the full approach, we present data from a healthy subject, where the inspiration and expiration periods during voluntary breathing were discriminated with a 92% accuracy (10-fold cross-validation) from the scalp EEG data. The paper ends with a discussion on the advantages and obstacles that can be forecasted in this novel application of the concept of BCI.
Highlights
Breathing insures the exchange of oxygen and carbon dioxide between the air and the blood to maintain essential functions of the organs of the body on a moment by moment basis [1]
In this paper we have introduced the concept of a patient ventilator interface (PVI) as a new field of application of the experience gained over last decades in the development of motor oriented brain computer interfaces
On the other hand the transient nature of mechanical ventilation (MV), used mainly during short periods of time or during parts of the day, does not justify the use of permanent interfaces based on invasive methods using intracranial measurements
Summary
Breathing insures the exchange of oxygen and carbon dioxide between the air and the blood to maintain essential functions of the organs of the body on a moment by moment basis [1]. Other clinical conditions [3], e.g., acute respiratory failure, coma, chronic obstructive pulmonary disease or neuromuscular disorders require the use of mechanical ventilation (MV) to decrease the work of breathing in the patients. The potential of BCIs to establish direct communication pathways between the brain and other external devices such as mechanical ventilators remains largely unexplored. This is surprising as the amount of patients that might benefit from advances in the BCI technology to control mechanical ventilation devices is considerably larger than the number of patients requiring BCI for motor control. Mechanical Ventilation and Neural Signals Associated to Voluntary and Involuntary Breathing
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