Functionalised optical fibre multiparameter sensing platform for monitoring during artificial ventilation
Lead Research Organisation:
University of Nottingham
Department Name: Div of Electrical Systems and Optics
Abstract
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).
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).
Planned Impact
The major beneficiaries of this research will be patients and clinicians. Over 1 million endotracheal tubes (ETT) are placed in patients' tracheas during surgery to support artificial ventilation and/or protect the lungs from inhalation of blood or gastric contents. At any time, around 2000 patients on Intensive Care Units (ICUs) in the UK are receiving artificial ventilation via ETTs, and annually around 20,000 emergency patients require these devices in Emergency Departments. The presence of an ETT is associated with very significant problems such as ventilator associated pneumonia (VAP). The inclusion of a monitoring system within the ETT would enable clinicians to monitor more closely the development of VAP and to intervene at an earlier stage, potentially preventing the causes of VAP. This could facilitate personalised treatment, thus increasing the quality of healthcare. The developed instrument will also have significant impact on the development of hospital instruments and equipment that saves lives; cheap, ubiquitous and instant diagnostics in ICU to increase patient comfort and potentially to prevent the over prescription of antibiotics. This would reduce healthcare cost considerably, as VAP treatment is a >£nbn problem worldwide.
Crucially, this proposal will develop a sensing platform that is inherently adaptable to tackle a range of health care challenges such as early diagnostics, point-of-care sensors, improved patient treatments, antibacterial resistance and personalised medicine. It is anticipated that successful demonstration of its applicability within a clinical environment under this project will lead to the development of commercial instrumentation and clinical trials. Industry involvement via P3 Medical, UK based medical instrument/equipment manufacturing company will insure smooth transition into the market. The proposal will provide strong proof of concept to inform future applications to MRC DPFS/DCS, NIHR (i4i) or Innovate UK Biocatalyst streams to develop the prototype and test in larger clinical trials.
In ICU the developed sensing platform embedded into ETT will:
- Alert clinicians to the accumulation of a microbial reservoir and the presence of common dangerous pathogens, allowing early intervention.
- Help with the diagnosis of VAP, which is notoriously problematic.
- Enable targeted therapy, reducing the need for broad-spectrum antimicrobials, which encourages resistance.
- Provide a highly cost-effective device for reducing VAP incidence since the light source, fibres and electronics are inherently low cost.
The Healthcare Technologies Futures Forum recognised that, over the long term, the availability of low cost, robust, non-invasive technologies capable of providing early diagnosis will impact on the wellbeing of the population, which will have a positive impact on economic activity and productivity, and reduce health service spending. It has been recognised in the Maxwell report that "precision medicine will also become increasingly important in the future, providing tailored healthcare solutions to patients and clinical decision makers" with technology playing a "pivotal role in advances across the field, such as the power of sensors, smartphone technologies and big data computing analysis."
Crucially, this proposal will develop a sensing platform that is inherently adaptable to tackle a range of health care challenges such as early diagnostics, point-of-care sensors, improved patient treatments, antibacterial resistance and personalised medicine. It is anticipated that successful demonstration of its applicability within a clinical environment under this project will lead to the development of commercial instrumentation and clinical trials. Industry involvement via P3 Medical, UK based medical instrument/equipment manufacturing company will insure smooth transition into the market. The proposal will provide strong proof of concept to inform future applications to MRC DPFS/DCS, NIHR (i4i) or Innovate UK Biocatalyst streams to develop the prototype and test in larger clinical trials.
In ICU the developed sensing platform embedded into ETT will:
- Alert clinicians to the accumulation of a microbial reservoir and the presence of common dangerous pathogens, allowing early intervention.
- Help with the diagnosis of VAP, which is notoriously problematic.
- Enable targeted therapy, reducing the need for broad-spectrum antimicrobials, which encourages resistance.
- Provide a highly cost-effective device for reducing VAP incidence since the light source, fibres and electronics are inherently low cost.
The Healthcare Technologies Futures Forum recognised that, over the long term, the availability of low cost, robust, non-invasive technologies capable of providing early diagnosis will impact on the wellbeing of the population, which will have a positive impact on economic activity and productivity, and reduce health service spending. It has been recognised in the Maxwell report that "precision medicine will also become increasingly important in the future, providing tailored healthcare solutions to patients and clinical decision makers" with technology playing a "pivotal role in advances across the field, such as the power of sensors, smartphone technologies and big data computing analysis."
Publications
Liu L
(2019)
A reflection-mode fibre-optic sensor for breath carbon dioxide measurement in healthcare
in Sensing and Bio-Sensing Research
Liu L
(2018)
Highly sensitive label-free antibody detection using a long period fibre grating sensor
in Sensors and Actuators B: Chemical
Kurmoo Y
(2020)
Real time monitoring of biofilm formation on coated medical devices for the reduction and interception of bacterial infections.
in Biomaterials science
Korposh S
(2019)
Tapered Optical Fibre Sensors: Current Trends and Future Perspectives.
in Sensors (Basel, Switzerland)
Hromadka J
(2019)
Simultaneous in situ temperature and relative humidity monitoring in mechanical ventilators using an array of functionalised optical fibre long period grating sensors
in Sensors and Actuators B: Chemical
Hromadka J
(2018)
Carbon dioxide measurements using long period grating optical fibre sensor coated with metal organic framework HKUST-1
in Sensors and Actuators B: Chemical
Hromadka J
(2017)
Multi-parameter measurements using optical fibre long period gratings for indoor air quality monitoring
in Sensors and Actuators B: Chemical
Hromadka J
(2018)
Highly sensitive volatile organic compounds vapour measurements using a long period grating optical fibre sensor coated with metal organic framework ZIF-8
in Sensors and Actuators B: Chemical
Description | Optical fibre sensor to measure humidity and temperature has been developed in tested using mechanical ventilator. Sensor shows good response to oscillating humidity and temperature changes. the biosensor showed good response to the growing of biofilm. Specially designed in school of Pharmacy smart materials coated onto optical fibre sensors indicate the possibility of identifying the type of bacteria attached to the ETT. |
Exploitation Route | New findings are useful for clinicians as novel sensors will allow to monitor air quality delivered to lungs during artificial ventilation. |
Sectors | Healthcare |
Description | The first test with human volunteers covered by university ethics on measurements of humidity and temperature in clinical settings have been commenced. |
First Year Of Impact | 2017 |
Sector | Healthcare |
Impact Types | Societal |
Description | MICA: iTraXS (intra Tracheal Multiplexed Sensing): an optical sensor equipped endotracheal tube |
Amount | £850,099 (GBP) |
Funding ID | MR/T025638/1 |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 11/2020 |
End | 12/2024 |
Description | Volatile organic compound sensing in healthcare using optical interrogation of metal-organic frameworks |
Amount | £671,742 (GBP) |
Funding ID | EP/V055410/1 |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 01/2022 |
End | 08/2025 |
Description | Nottingham University Hospital Trust |
Organisation | Nottingham University Hospitals NHS Trust |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Novel sensors for clinicians at Nottingham University Hospital Trust that can be sued for intensive care measurements |
Collaborator Contribution | consultation on parameters that need to be measured during artificial ventilation. |
Impact | This is highly multidisciplinary collaboration that resulted in several publications on measurements using endotracheal tubes. |
Start Year | 2014 |
Description | Open days |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Open day activity exhibited developed sensors as a promotion for final year projects at UoN. |
Year(s) Of Engagement Activity | 2017,2018 |
Description | Workshop |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Workshop with clinicians and academics . |
Year(s) Of Engagement Activity | 2017,2018 |