Developmental Clinical Studies-validation of the utility of a novel smartprobe detecting neutrophil activation/elastase activity in acute lung injury

重症监护室（ICU）中40%的患者需要呼吸机来支持肺部，并伴有许多相关并发症。目前，临床恶化的主要指征是胸部X线片上阴影的存在/扩散。这有许多不同的原因（都需要不同的治疗方法）。迫切需要快速床旁测试，以提供有关肺部本身发生的情况的明确诊断信息。许多研究都使用了血液标记物，但在多系统疾病患者中，这些标记物并不特异于肺部，而且结果太慢，无法用于快速变化的ICU环境。我们将采用尖端技术，将一根微小的光纤深入通气患者的肺部，并喷洒“微量”显像剂，这将告诉我们肺部恶化的原因。这种方法有可能在床旁快速确定肺部阴影是否由炎症引起。这种方法可以彻底改变我们处理重症患者的方式，并提供快速的护理点诊断，这将有助于定制患者的管理。

40% of all patients in the intensive care unit (ICU) need a ventilator to support their lungs, with many associated complications. Currently the main indication of clinical deterioration is the presence/spreading of shadowing on the chest x- ray. This has many different causes (all requiring different treatments). There is a pressing need for rapid bedside tests to provide definitive diagnostic information about what is happening in the lungs themselves. Many studies have used blood markers, but in patients with multi-system disease these are not specific for the lung and the results are too slow to be useful in the rapidly-changing ICU setting.We will employ cutting-edge technology to pass a tiny optical fibre deep into the lungs of ventilated patients and spray a 'microdose' of an imaging agent that will tell us the reasons for the lung deterioration. This approach has the potential to rapidly determine, at the bedside, if the lung shadowing is due to inflammation. Such an approach could revolutionise the way we deal with the critically ill patient and provide rapid, point of care diagnostics that would help tailor the patient's management.