Prospective Observational Multimodal Neuromonitoring During High-Risk Adult Surgery

This is a prospective observational cohort study of adult patients undergoing high-risk surgery at UT Southwestern Medical Center. The study acquires synchronized multimodal neuromonitoring data - including SedLine quantitative EEG (qEEG) extracted from standard-of-care clinical monitoring and, where deployed, Brain4Care (B4C) noninvasive intracranial dynamics data - and links these data to perioperative hemodynamic, medication, laboratory, procedural, and outcome variables. No alteration of routine clinical care occurs. The primary goal is to characterize associations between monitor-derived features and perioperative clinical variables, and to establish a multimodal dataset supporting future analyses of perioperative brain health in high-risk surgical populations.

Inclusion Criteria: * Age 18 years or older * Scheduled to undergo major spine surgery, liver transplantation, on-pump cardiac surgery, major vascular surgery, major thoracic surgery, major abdominal surgery, or neurosurgical craniotomy at UT Southwestern Medical Center * Able to provide informed consent (self or legally authorized representative when applicable) * Safe and feasible placement of SedLine and/or Brain4Care monitoring as determined by the clinical and research teams * Anticipated availability of perioperative clinical data needed for study analyses Exclusion Criteria: * Age younger than 18 years * Prisoner status * Pregnancy * Unable to provide informed consent in English (consent documents available in English only) * Declining participation * Lack of subject or legally authorized representative consent when required * Clinical condition preventing safe or feasible placement of study monitors (e.g., incompatible surgical field location, significant facial or scalp injury, open wounds at intended sensor placement site) * Operative workflow or clinical urgency precluding reasonable completion of consent and monitor placement prior to start of surgery * Anticipated clinical data capture insufficient for meaningful analysis