SCF AUTONOMIC NEURO-MULTISYSTEMS SURVEILLANCE ENGINE (ANMS)

Clinical Positioning Program

Project RHENOVA Critical Care Intelligence Platform

Program Code: SCF-ANMS-0001

Classification: Critical Care Surveillance, Predictive Physiology, Multi-System Failure Prevention, Recovery Intelligence

Parent Platform: SCF-DBI Universal ICU Surveillance System (SCF-DBI-UISS-0001)

EXECUTIVE POSITIONING STATEMENT

The SCF Autonomic Neuro-Multisystems Surveillance Engine (ANMS) is the master surveillance and prediction layer of the SCF-DBI Critical Care Medicine System.

Its purpose is to detect early destabilization of biological control systems before conventional signs of organ failure become clinically apparent.

Traditional ICU monitoring focuses on:

Heart rate
Blood pressure
Oxygenation
Organ function
Laboratory abnormalities

ANMS focuses on:

The integrity of autonomic biological communication networks that coordinate survival.

Under the SCF framework, critical illness is viewed as a progressive failure of interconnected neurobiological control systems rather than isolated organ dysfunction.

SECTION I

BIOLOGICAL FOUNDATION

Core Hypothesis

The autonomic nervous system acts as the master regulator linking:

Brain
Heart
Immune system
Vasculature
Endocrine system
Metabolism
Regenerative systems

When these systems lose synchronization, physiologic collapse follows.

ANMS was designed to identify this loss of synchronization.

SECTION II

THE FIVE PRIMARY ANMS DOMAINS

Domain 1

Neuroimmune Intelligence

Function

Coordinates communication between:

CNS
Innate immunity
Adaptive immunity

Clinical Failure States

Sepsis
Cytokine storm
Hyperinflammation
Immune paralysis
ICU encephalopathy

Surveillance Variables

Cytokines

IL-6
IL-1β
TNF-α
IFN-γ
IL-10

Immune Regulation

Treg activity
HLA-DR expression

Inflammatory Balance

Pro-inflammatory index
Anti-inflammatory index

Output

Neuroimmune Stability Score (NISS)

Domain 2

Neurocardiac Intelligence

Function

Coordinates autonomic control of:

Cardiac output
Heart rate
Perfusion
Oxygen delivery

Clinical Failure States

Septic shock
Cardiogenic shock
Arrhythmias
Sudden decompensation

Surveillance Variables

Physiologic

HRV
Heart rate
Blood pressure variability

Cardiac Biomarkers

Troponin
BNP
Lactate

Output

Neurocardiac Resilience Score (NCRS)

Domain 3

Neurovascular Intelligence

Function

Coordinates:

Endothelial signaling
Microvascular perfusion
Capillary integrity

Clinical Failure States

ARDS
Capillary leak syndrome
Shock
Multi-organ dysfunction

Surveillance Variables

Endothelial Biomarkers

Angiopoietin-2
vWF
ICAM-1
VCAM-1

Perfusion Indicators

Lactate clearance
Capillary refill
Tissue oxygenation

Output

Endothelial Integrity Index (EII)

Domain 4

Neurometabolic Intelligence

Function

Coordinates cellular energy production.

Clinical Failure States

Mitochondrial dysfunction
Tissue hypoxia
Organ failure

Surveillance Variables

Energy Markers

Lactate
Pyruvate
Ketones

Metabolic Markers

Glucose variability
Oxygen extraction

Output

Metabolic Resilience Score (MRS)

Domain 5

Neuroendocrine Intelligence

Function

Coordinates stress adaptation.

Clinical Failure States

Adrenal dysfunction
Persistent critical illness
Refractory shock

Surveillance Variables

Hormonal Markers

Cortisol
ACTH
Vasopressin
Catecholamines

Output

Adaptive Stress Index (ASI)

SECTION III

THE ANMS INDEX

The ANMS Index integrates all five domains.

Mathematical Framework

Conceptually:

ANMS =

Neuroimmune +

Neurocardiac +

Neurovascular +

Neurometabolic +

Neuroendocrine

normalized into a 0–100 scale.

Domain Weighting

Domain	Weight
Neuroimmune	20%
Neurocardiac	20%
Neurovascular	20%
Neurometabolic	20%
Neuroendocrine	20%

SECTION IV

RISK CLASSIFICATION

Green Zone

ANMS >80

Characteristics:

Physiologic stability
Adaptive reserve intact
Low collapse risk

Yellow Zone

ANMS 60–79

Characteristics:

Early compensatory stress
Increased surveillance required

Orange Zone

ANMS 40–59

Characteristics:

Loss of biologic reserve
Impending decompensation

Red Zone

ANMS <40

Characteristics:

High collapse risk
Multi-system destabilization

Black Zone (Proposed RHENOVA Extension)

ANMS <20

Characteristics:

Refractory shock
Severe MODS
ECMO/CRRT-level rescue consideration

SECTION V

SHOCK PREDICTION APPLICATION

ANMS functions as an upstream shock-detection platform.

Traditional ICU detects:

Hypotension
Elevated lactate
Organ dysfunction

ANMS attempts to identify:

Pre-Shock State

Before:

Blood pressure falls
Lactate rises significantly
Organ injury becomes evident

Shock Phenotypes

Neuroimmune Shock

Dominated by inflammatory dysregulation.

Neurocardiac Shock

Dominated by autonomic-cardiac failure.

Neurovascular Shock

Dominated by endothelial collapse.

Neurometabolic Shock

Dominated by bioenergetic failure.

Neuroendocrine Shock

Dominated by maladaptive stress responses.

SECTION VI

ENCEPHALOPATHY PREDICTION APPLICATION

A major objective of ANMS is prevention of ICU encephalopathy.

Monitored Variables

HRV

Cytokine Burden

Neurofilament Light

GFAP

EEG Changes

Sleep Disruption Metrics

ANMS Neurologic Output

Encephalopathy Risk Index (ERI)

Predicts:

Delirium
Cognitive decline
Neuroinflammatory deterioration

SECTION VII

RHENOVA CDSS INTEGRATION

ANMS functions as the primary input layer for the RHENOVA Critical Care Decision Support System.

CDSS Outputs

Shock Prediction

Sepsis Prediction

ARDS Prediction

Encephalopathy Prediction

Recovery Prediction

ICU Length-of-Stay Prediction

Fibrosis Risk Prediction

Mortality Risk Stratification

SECTION VIII

ICU ESCALATION LOGIC

ANMS Decline >10%

Enhanced surveillance.

ANMS Decline >20%

Activate preventive bundle.

ANMS Decline >30%

Activate rescue bundle.

ANMS Decline >40%

Multi-specialty critical response.

SECTION IX

RECOVERY INTELLIGENCE APPLICATION

ANMS is used beyond acute stabilization.

Recovery Targets

Neuroimmune Recovery

Endothelial Recovery

Mitochondrial Recovery

Cognitive Recovery

Functional Recovery

Recovery Endpoint

ANMS >80 sustained for 48–72 hours.

SECTION X

STRATEGIC POSITIONING WITHIN SCF-DBI

The ANMS Engine serves as the equivalent of a physiologic “early warning radar” for the entire SCF-DBI Critical Care System.

Its primary purpose is to identify loss of synchronization among autonomic biological networks before conventional organ failure occurs, enabling earlier intervention, more targeted monitoring, and more structured recovery planning.

It functions as the central surveillance layer linking:

SCF-PCR Critical Care Logic
Universal ICU Surveillance System
Self-Tolerance Recovery Index (STRI)
RHENOVA Recovery Intelligence Platform
Multi-System Collapse Prevention Program

MASTER REGISTRY INDEX

SCF-ANMS-0001 — Autonomic Neuro-Multisystems Surveillance Engine

SCF-ANMS-NI-0001 — Neuroimmune Intelligence Module

SCF-ANMS-NC-0001 — Neurocardiac Intelligence Module

SCF-ANMS-NV-0001 — Neurovascular Intelligence Module

SCF-ANMS-NM-0001 — Neurometabolic Intelligence Module

SCF-ANMS-NE-0001 — Neuroendocrine Intelligence Module

SCF-ANMS-ERI-0001 — Encephalopathy Risk Index

SCF-ANMS-SPI-0001 — Shock Prediction Interface

SCF-RHENOVA-ANMS-0001 — RHENOVA Critical Care Surveillance Architecture

SCF-DBI-UISS-0001 — Universal ICU Surveillance System

SCF-DBI-MCPP-0001 — Multi-System Collapse Prevention Platform

SCF-DBI-PCR-0001 — Preventative-Curative-Restorative Critical Care Framework

Scientific Positioning Note

As presently defined, ANMS is a conceptual systems-engineering and critical-care informatics framework rather than a validated clinical scoring system. To become clinically deployable, it would require formal biomarker specification, algorithm development, prospective observational studies, calibration against established ICU outcomes (SOFA, PELOD, PRISM, APACHE, mortality, delirium, ICU LOS), and regulatory-grade validation before clinical use.