Instantaneous monitoring of heart beat dynamics during anesthesia and sedation

Anesthesia-induced altered arousal depends on drugs having their effect in specific brain regions. These effects are also reflected in autonomic nervous system (ANS) outflow dynamics. To this extent, instantaneous monitoring of ANS outflow, based on neurophysiological and computational modeling, may provide a more accurate assessment of the action of anesthetic agents on the cardiovascular system. This will aid anesthesia care providers in maintaining homeostatic equilibrium and help to minimize drug administration while maintaining antinociceptive effects. In previous studies, we established a point process paradigm for analyzing heartbeat dynamics and have successfully applied these methods to a wide range of cardiovascular data and protocols. We recently devised a novel instantaneous nonlinear assessment of ANS outflow, also suitable and effective for real-time monitoring of the fast hemodynamic and autonomic effects during induction and emergence from anesthesia. Our goal is to demonstrate that our framework is suitable for instantaneous monitoring of the ANS response during administration of a broad range of anesthetic drugs. Specifically, we compare the hemodynamic and autonomic effects in study participants undergoing propofol (PROP) and dexmedetomidine (DMED) administration. Our methods provide an instantaneous characterization of autonomic state at different stages of sedation and anesthesia by tracking autonomic dynamics at very high time-resolution. Our results suggest that refined methods for analyzing linear and nonlinear heartbeat dynamics during administration of specific anesthetic drugs are able to overcome nonstationary limitations as well as reducing inter-subject variability, thus providing a potential real-time monitoring approach for patients receiving anesthesia

Nuclear Equation of state for Compact Stars and Supernovae

International audienceThe equation of state (EoS) of hot and dense matter is a fundamental input to describe static and dynamical properties of neutron stars, core-collapse supernovae and binary compact-star mergers. We review the current status of the EoS for compact objects, that have been studied with both ab-initio many-body approaches and phenomenological models. We limit ourselves to the description of EoSs with purely nucleonic degrees of freedom, disregarding the appearance of strange baryonic matter and/or quark matter. We compare the theoretical predictions with different data coming from both nuclear physics experiments and astrophysical observations. Combining the complementary information thus obtained greatly enriches our insights into the dense nuclear matter properties. Current challenges in the description of the EoS are also discussed, mainly focusing on the model dependence of the constraints extracted from either experimental or observational data (specifically, concerning the symmetry energy), the lack of a consistent and rigorous many-body treatment at zero and finite temperature of the matter encountered in compact stars (e.g. problem of cluster formation and extension of the EoS to very high temperatures), the role of nucleonic three-body forces, and the dependence of the direct URCA processes on the EoS