Noninvasive Functional Biomarker for Early Detection and Continuous Monitoring of Microvascular Dysfunction

有些人与细菌感染必须承认到医院重症监护室（CCU），因为感染引起 过度的炎症反应导致器官衰竭医生将其定义为败血症。没有其他的治疗方法 比抗生素和支持疗法更有效一旦患者被诊断为败血症，死亡率从 25%到40%临床证据表明，早期发现和积极治疗，以维持组织氧合，减少 死亡率显著;然而，除了器官损害的证据外，没有工具或血液检查来诊断脓毒症的发作。 到那时，许多器官已经受到严重损伤。对于那些幸存下来的人来说，没有人完全康复， 第一年死亡率仍然很高。 利用脓毒症的动物模型，我们的研究表明器官衰竭是由于小血管的损伤 （微血管）堵塞50%的毛细血管，使其不再输送氧气（O2）。这削弱了 微血管系统来调节O2供应以满足组织的O2需求。这种微血管损伤是导致器官 失败最近，我们发现了微血管血流和氧气水平的独特模式，这些模式可以区分 健康和受损的微血管。我们开发了一种简单的非侵入性光学方法来跟踪这种微血管 签名.我们的目标是在患者发生器官衰竭之前检测微血管损伤的发生， 治疗是否能恢复微血管功能我们已经组建了一个新的研究小组来开发 技术.原型设备将在我们的先进生物医学设备设计和制造设施中制造， 在我们的光学和流动模拟设施中进行了优化，并在脓毒症动物、健康志愿者以及最终在 患者在CCU。早期发现有可能挽救生命，降低医疗保健成本，并使加拿大成为全球 脓毒症治疗的领导者。

Some people with a bacterial infection must be admitted to a hospital Critical Care Unit (CCU) because the infection caused an excessive inflammatory response, which resulted in organ failure. Doctors define this as sepsis. There is no cure other than administration of antibiotics and supportive therapies. Once a patient is diagnosed with sepsis, mortality rates are from 25 to 40%. Clinical evidence shows that early detection and aggressive treatment to maintain tissue oxygenation, reduces mortality significantly; however, there is no tool or blood test to diagnose the onset of sepsis other than evidence of organ failure and by then many organs have experienced severe injury. For those who survive, none fully recover and during the first year mortality rates remains high. Using animal models of sepsis our research shows that organ failure is due to injury to small blood vessels (microvasculature) that plugs 50% of capillaries so they no longer deliver oxygen (O2). This impairs the ability of the microvasculature to regulate O2 supply to meet O2 needs of the tissue. This microvascular injury is responsible for organ failure. Recently we discovered unique patterns of microvascular blood flow and oxygen levels that distinguish between a healthy and damaged microvasculature. We developed a simple non-invasive optical method to track this microvascular signature. Our goal is to detect the onset of micovascular injury before patients develop organ failure and to monitor whether treatment is restoring microvascular function. We have assembled a new team of researchers to develop the technology. Prototype devices will be made in our Facility for Advanced Biomedical Device Design and Fabrication, optimized in our Facility for Optics and Flow Simulation and validated in septic animals, healthy volunteers and finally on patients in CCUs. Early detection has the potential to save lives, reduce health care costs and place Canada as a global leader in the treatment of sepsis.