Title: COMMIT - Continuous Online Metabolite Monitoring.
Funder: Department of Health and Social Care

Abstract: Background: The largest single cause of death in people aged Aim: Development of a low-cost continuous &ldquo;real-time&rdquo; brain chemistry online sensor for use in critical care of severe TBI patients. Design & Methods: We have established proof-of-concept, in the laboratory and in neurocritical care TBI patients, for a novel sensor for glucose, lactate and pyruvate, the three most important substances monitored hourly by the existing bedside analyser. Our sensor utilises infra-red spectroscopy monitoring continuously online, not requiring manual transfer or expensive consumables. We will optimise our sensor and further evaluate it online in patients, and integrate results with brain pressure and oxygen. We will continue working with Cambridge Enterprise on patenting which we have initialised. We will begin to commercialise our sensor by engaging with a small-medium enterprise UK company. Project outcome: Our sensor will create opportunities for improvements in patient treatment. Development of our sensor will facilitate deployment of microdialysis monitoring of TBI patients to many more critical-care units.

Lay abstract: Background:The largest single cause of death in people under 40 is traumatic brain injury (TBI) resulting from motor accidents, falls, assaults etc. TBI is also rising with ageing populations (e.g. as a result of falls). People with severe TBI are cared for initially in an Intensive Care Unit in order to support and monitor their needs at a critical stage of their recovery. Many aspects of the TBI patient s condition are monitored, including blood tests, brain oxygen levels, and brain pressure. Also the natural fluid within the brain, which is a highly specialised blend of complex vital components, is tested regularly to assess the fluctuating state of the brain during this critical time. Currently, testing brain fluid takes an hour for results to be available and treatment adjusted, but within that hour there may be changes that go unaddressed. The aim of this project is to develop a means to continuously monitor this fluid, so treatment may be more responsive to the individual needs of the patient. The more responsive treatment can be, the faster recovery will be. The faster the recovery, the sooner patients can be discharged from the Intensive Care Unit to the next stage of their recovery. Aim:To develop a low-cost continuous &ldquo;real-time&rdquo; brain chemistry online sensor for use in critical care of severe TBI patients. PPI: Patients, carers, other members of the public, and end-users (e.g. nurses) will be involved, including through the charity Headway (of which the PI Prof Peter Hutchinson is a professional advisor), the NIHR Medtech and In vitro diagnostics Co-operative (MIC), and our PPI collaborator, Mr Jeremy Dearling, a previous critical care patient. Design & Methods:We have established proof-of-concept, both in the laboratory and on neurocritical care TBI patients, for a novel sensor for glucose, lactate and pyruvate, the three most important substances monitored hourly by the existing bedside equipment. Our new sensor utilises a technique called infra-red spectroscopy that monitors continuously online, and does not require manual transfer or the expensive consumables used in existing bedside analysers. We propose to optimise our sensor, and will further evaluate it online at the bedside and integrate its measurements with monitoring of brain pressure and oxygen. We will continue to work with Cambridge Enterprise, continuing the patenting process we have initialised, and we will begin to commercialise our sensor by engaging with a small-medium enterprise UK company. Project outcome: Our new technology will create opportunities for improvements in patient treatment. Fast detection is also is particularly important in paediatric patients whose brains are even more dynamic than in adults. Development of our sensor will assist in the deployment of microdialysis monitoring of brain-injury patients to many more hospitals critical-care units and paediatric critical-care units.

Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES;4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: INJURIES AND ACCIDENTS