# Developing an Integrated Brain State Monitor for Personalized Anesthesia Decision Support: Preventing Postoperative Delirium in Elderly and Patients At Risk for Alzheimer's or Related Dementias

> **NIH NIH R44** · PASCALL SYSTEMS, INCORPORATED · 2024 · $499,968

## Abstract

Each day, more than 100,000 patients undergo general anesthesia in the United States. 40 percent of
the patients receiving anesthesia care are 60 years or older. Post-operative delirium (POD) in these patients has
been recognized as a major problem since at least the 1950’s. This project addresses the heightened risk of
post-operative delirium (POD) in elderly patients, particularly those with Alzheimer’s disease and related
dementias. Existing interventions, like geriatrician involvement and hospital elder life programs (HELP), have
shown promise, but their implementation in hospital systems is challenging. Furthermore, current EEG monitors
like Medtronic BIS have shown mixed efficacy in POD prevention. Responding to this gap, the PASCALL shall
introduces neuroscience-based personalized anesthesia management by integrating our FDA-cleared
Wireless Monitor (M0) with Electronic Medical Record (EMR), infusion pumps and anesthesia machine
to obtain the needed information to personalize anesthesia decision support. In Aim 1, we seek to establish
technical feasibility in connecting with these external systems and devices. In Aim 2, we shall develop the next-
generation integrated brain monitoring system (M1) to be FDA-submission ready under appropriate FDA
guidance, ISO and ICE standards. In Aim 3, we focus on developing M1 clinical decision support features: 1)
accurate age-compensated brain state tracking, 2) anesthetic dose guidance, and 3) POD risk prediction.
We shall validate these features using our expansive datasets of N=108,968 subjects across 4 studies. In Aim
4, we shall work with the FDA to determine the regulatory requirements and discuss clinical trial planning.

## Key facts

- **NIH application ID:** 10921860
- **Project number:** 1R44AG087872-01
- **Recipient organization:** PASCALL SYSTEMS, INCORPORATED
- **Principal Investigator:** David Arney
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $499,968
- **Award type:** 1
- **Project period:** 2024-08-15 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10921860

## Citation

> US National Institutes of Health, RePORTER application 10921860, Developing an Integrated Brain State Monitor for Personalized Anesthesia Decision Support: Preventing Postoperative Delirium in Elderly and Patients At Risk for Alzheimer's or Related Dementias (1R44AG087872-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10921860. Licensed CC0.

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