A miniaturised laser isotope ratiometer for early diagnosis of sepsis by exhaled breath analysis

小型激光同位素比率计通过呼出气分析早期诊断脓毒症

• 批准号: ST/S000690/1
• 负责人: Mark McPhail
• 金额: $ 9.38万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ST%2FS000690%2F1
• 关键词: miniaturised; laser; isotope; ratiometer; early

This project aims to develop a prototype medical instrument for the rapid and accurate diagnosis of sepsis. Sepsis is a serious complication of infections, and without timely treatment can lead to multiple organ failure and death. In the UK 44,000 deaths per annum are attributed to sepsis, and 14,000 of those are thought to be preventable with improved diagnosis and reduced delays in beginning treatment. Delays in treatment of just a few hours can have a significant impact on the outcome for the patient. Current tests for sepsis require samples of blood or other fluid from the patient to be taken to a laboratory for analysis. There are two drawbacks associated with current testing: Firstly, the process of sending samples for analysis introduces delay, which in turn reduces the chances of successful treatment; secondly, patients cannot be monitored continuously and so the onset of the condition may be missed.Researchers at the Rutherford Appleton Laboratory (RAL) have developed an instrument called a laser isotope ratiometer (LIR) that should be able to identify the very early stages of sepsis by analysing the composition of exhaled breath from the patient. Changes in the ratio of naturally occurring forms carbon dioxide exhaled by patients can indicate the presence of sepsis. The LIR will be capable detecting these changes in real time by analysing subtle changes in the infrared light absorbed by the exhaled breath. Crucially the results of this analysis will be interpreted by the instrument and presented to medical staff as a simple "yes" or "no" indication of whether the patient has sepsis or not. The method is non-invasive and, for the sickest patients that are not able to breathe for themselves, the LIR could be attached to ventilators to provide continuous monitoring.During the project the instrument scientists at RAL will work with clinicians at King's College London (KCL) to determine whether the LIR can provide a reliable way of identifying patients with sepsis. This will be done through clinical trials where KCL will provide anonymised sample bags containing exhaled breath from patients with and without sepsis for blind testing by the LIR at RAL.The LIR has been successfully demonstrated in other application areas, and is being exploited commercially for the oil and gas industry. During this project the work at RAL will include preparation of an existing miniaturised version of the LIR for breath analysis, characterization of its performance, and development of the test protocol to ensure accuracy and reliability. If initial tests using sample bags are successful there will be an opportunity for the LIR to be deployed in a clinical environment at King's College Hospital for further testing. This will enable a better idea of the effectiveness of the approach, including potential cost savings.

本项目旨在开发一种用于快速准确诊断脓毒症的原型医疗仪器。脓毒症是感染的严重并发症，如不及时治疗可导致多器官功能衰竭和死亡。在英国，每年有44，000例死亡归因于败血症，其中14，000例被认为是可以通过改善诊断和减少治疗延迟来预防的。仅仅几个小时的治疗延迟就可能对患者的结果产生重大影响。目前的败血症检测需要将患者的血液或其他液体样本带到实验室进行分析。目前的检测有两个缺点：第一，发送样本进行分析的过程造成了延误，这反过来又减少了成功治疗的机会;其次，卢瑟福阿普尔顿实验室（RAL）的研究人员开发了一种称为激光同位素比率计（LIR）的仪器，通过分析病人呼出气体的成分，应该能够识别脓毒症的早期阶段。患者呼出的天然形式二氧化碳的比例变化可以指示脓毒症的存在。LIR将能够通过分析呼出气体吸收的红外光的细微变化来检测真实的时间的这些变化。至关重要的是，该分析的结果将由仪器解释并呈现给医务人员，作为患者是否患有败血症的简单“是”或“否”指示。该方法是非侵入性的，对于那些不能自主呼吸的重症患者，可以将LIR连接到呼吸机上，以提供持续的监测。在该项目中，RAL的仪器科学家将与伦敦国王学院（KCL）的临床医生合作，以确定LIR是否可以提供一种可靠的方法来识别败血症患者。这将通过临床试验来完成，KCL将提供含有败血症和非败血症患者呼出气体的匿名样本袋，供RAL的LIR进行盲法测试。LIR已在其他应用领域得到成功证明，并正在石油和天然气行业进行商业开发。在该项目期间，RAL的工作将包括准备用于呼吸分析的现有LIR的简化版本，表征其性能，并制定测试协议以确保准确性和可靠性。如果使用样品袋的初步测试成功，LIR将有机会部署在国王学院医院的临床环境中进行进一步测试。这将有助于更好地了解该方法的有效性，包括潜在的成本节约。