Functionalised optical fibre multiparameter sensing platform for monitoring during artificial ventilation

呼吸机相关性肺炎（VAP）是一个主要的健康问题，导致死亡，延长重症监护病房（ICU）住院时间，并在全球范围内造成100亿英镑的损失。气管导管定植和生物膜形成在VAP中起关键作用。机械通气患者的呼吸功能维持需要适当的加湿，即使在无创通气中，吸入空气加湿和加热不足也会导致鼻黏膜功能恶化，并可能导致VAP。因此，加湿和温度是现代重症监护实践的重要因素。目前，还没有技术可用于在ETT或输送到肺部的人工空气的湿度和温度上进行生物膜生长的原位测量。该项目将利用基于光纤长周期光栅阵列的尖端传感技术，为临床环境生产多参数仪器原型，以降低VAP风险，帮助早期诊断和指导治疗。光纤传感器阵列的每个传感元件将使用合适的敏感层进行修改，以实现对ETT关键参数（如温度、湿度和生物膜形成）的最佳响应。新型先进材料如分子印迹和介孔功能膜将被用作敏感层。在项目过程中，该设备将在临床设备上进行测试，通常用于ICU，在实验室环境中进行概念验证，以进行临床研究。该提案将技术推动与临床推动相结合，符合EPSRC确定的“优化治疗”大挑战的愿望，即通过有效的诊断、针对患者的预测和循证干预来解决护理优化问题。该提案本质上是多学科的，结合了光子学、化学和分析科学的专业知识。通过诺丁汉大学医院信托基金会的Andy Norris博士的参与和ETT制造商（P3 Medical，一家专门制造创新气道设备的英国中小企业）的参与，研究的产出和影响将最大化。

Ventilator Associated Pneumonia (VAP) is a major health problem resulting in death, prolonged intensive care unit (ICU) stay and costs of >£nbn worldwide. Endotracheal tube colonization and biofilm formation play a key role in VAP. Maintenance of the respiratory function of mechanically ventilated patients requires adequate humidification, even in non-invasive ventilation in which inadequate humidification and heating of the inspired air has been associated with functional deterioration of nasal mucosa and can also lead to VAP. Thus, humidification and temperature are important factors of modern intensive care practice.At the present, there is no technology available to conduct in situ measurement of biofilm growth on an ETT or humidity and temperature of the artificial air delivered to the lungs.The project will exploit cutting edge sensing techniques based on an array of optical fibre long period gratings in order to produce a prototype multiparameter instrument for a clinical setting to reduce VAP risk, aid early diagnosis and guide treatment. Each sensing element of the optical fibre sensor array will be modified using an appropriate sensitive layer to achieve optimal response to the key parameters of the ETT, such as temperature, humidity and biofilm formation. Novel advanced materials such as molecular imprinting and mesoporous functional films will be utilised as sensitive layers. During the course of the project the device will be tested on clinical equipment, typically used in ICU, in a laboratory setting to demonstrate proof of concept to proceed to clinical studies. The proposal combines technology push with clinical pull and matches the aspirations of the "Optimising Treatment" Grand Challenge identified by EPSRC to address the optimisation of care through effective diagnosis, patient-specific prediction and evidence-based intervention. The proposal is multidisciplinary in nature combining expertise in photonics, chemistry and analytical science. The output and impact of the research will be maximised through the involvement of Dr Andy Norris at Nottingham University Hospitals Trust and the involvement of an ETT manufacturer (P3 Medical, a UK SME specialising in the manufacture of innovative, airway devices).