Realtime Monitoring of Sublingual Blood Velocity

描述（由申请人提供）：项目总结/摘要：非冠状动脉重症监护病房住院患者最常见的死亡原因是败血症。尽管有干预措施，败血症每年影响超过80万美国人，导致30%至80%的死亡率，每年导致超过25万人死亡，费用为167亿美元。一年内死于严重脓毒症的美国人比死于乳腺癌、肺癌和中风的总和还要多。对ICU患者中早发型和晚发型感染性休克的发病率和死亡率差异的研究发现，早发型感染性休克更严重，表现为更严重的器官功能障碍、更严重的乳酸酸中毒和更高的血管加压药需求，但结局更好，表现为休克发作持续时间更短、ICU停留时间更短和死亡率略低。早期发现脓毒症将是更有效的诊断方式结合血流动力学监测，中心静脉血氧饱和度监测，舌下二氧化碳监测。大多数脓毒症和脓毒性休克的血流动力学研究评价了增加心输出量、血压和器官血流量的治疗策略。尽管皮肤和其他微循环领域已经开展了严格的研究活动，但到目前为止，还没有任何监测技术在可重复性方面得到验证。最近的研究表明，脓毒症患者舌下微循环血流改变，微循环改变的严重程度与生存率之间可能存在相关性。本研究的主要目的是探讨一种新的成像技术的实用性，实时，非侵入性，定量测量舌下和/或粘膜血流速度在人类的目的是提供信息脓毒症。本课题的创新之处在于应用舌下血流速度定量检测新技术监测脓毒症。这项研究的最终产品将是一个小型的手持设备，提供实时，非侵入性和定量测量舌下血流速度的目的，监测败血症在ICU。该设备将向临床医生提供关于患者微循环状态的重要信息，以允许应用更及时的干预措施。项目叙述：非冠心病重症监护病房住院患者最常见的死亡原因是败血症。脓毒症的发作改变了舌头的血液速度。本研究旨在探讨一种新的成像技术在重症监护病房中用于实时测量患者舌头血液流速的实用性。

DESCRIPTION (provided by applicant): Project Summary/Abstract: The most common cause of death among hospitalized patients in noncoronary intensive care units is sepsis. Despite interventions, sepsis affects more than 800,000 Americans each year, incurs a mortality rate of 30% to 80%, and causes more than 250,000 deaths per year, at a cost of $16.7 billion. More Americans die in 1 year from severe sepsis than from breast cancer, lung cancer, and stroke combined. An investigation of the differences in morbidity and mortality between early and late onset of septic shock in ICU patients found that septic shock is more severe when of early onset, as reflected by more severe organ dysfunction, greater lactic acidosis, and higher vasopressor requirements, yet the outcome is better, as reflected by a shorter duration of the shock episode, shorter ICU stay, and slightly lower mortality rates. Early detection of sepsis would be more effective when the diagnostic modalities are combined with hemodynamic monitoring, central venous O2 saturation monitoring, and sublingual capnography. Most hemodynamic studies in sepsis and septic shock evaluate therapeutic strategies to increase cardiac output, blood pressure, and organ blood flow. Even though the skin and other microcirculatory areas have enjoyed rigorous research activities, so far, no monitoring techniques have yet been validated in terms of reproducibility. Recent studies showed altered sublingual microcirculatory blood flow in septic patients and a possible correlation between the severity of microcirculatory alterations and survival. The main objective of this research is to investigate the utility of a new imaging technique for realtime, noninvasive, and quantitative measurements of sublingual and/or mucosal blood velocity in humans for the purpose of providing information on sepsis. The innovation of this project lies in the application of the new technique to measure, quantitatively, sublingual blood velocity for monitoring sepsis. The ultimate product of this research will be a small, handheld device that provides real-time, noninvasive, and quantitative measurements of sublingual blood velocity for the purpose of monitoring sepsis in ICUs. This device would provide vital information to the clinician on the state of the patient's microcirculation to allow the application of more timely interventions. Project Narrative: The most common cause of death among hospitalized patients in noncoronary intensive care units is sepsis. The onset of sepsis changes the blood velocities of the tongue. This research is to investigate the utility of a new imaging technique for real-time measurements of blood velocity of the patient's tongue in the intensive care units.