Development of a multi-parameter oesophageal sensor for the early detection of Multiple Organ Dysfunction Syndrome (MODS)
Dr M. Hickey
Professor R. M. Langford, St. Bartholomew’s Hospital
Patients in the intensive care unit (ICU) are extremely vulnerable to complications related to sepsis, an infection of the blood stream. Once sepsis takes hold, it can develop into more serious conditions such as septic shock and multiple organ dysfunction syndrome (MODS), both of which are associated with very high mortality rates. Approximately 19% of patients admitted to intensive care develop MODS, which is estimated to cause from 47% to 80% of deaths in the ICU. It is well known that patients who develop sepsis show a reduction in blood supply to the vital organs, even before other symptoms are apparent.
Monitoring the blood supply to the oesophagus (gullet), stomach or small intestine can therefore give an early warning of the onset of sepsis, allowing rapid treatment to prevent septic shock and MODS. Currently, there is no bedside monitor suitable of providing an early indication of inadequate oxygen supply in abdominal organ tissues. Patients who are undergoing major surgery or in the Intensive Care Unit (ICU) routinely have tubes or probes inserted into the gullet for the purposes of feeding, temperature measurement and other monitoring.
This work proposes to use a disposable optics-based probe to continuously monitor the oxygen and carbon dioxide levels in the wall of the lower gullet. This will provide valuable information regarding the adequacy of the blood supply to the gut and vital organs. The sensor will be evaluated in surgery and ICU patients. The sensor will not interfere with normal patient care and will be designed not to cause discomfort to the patient. The ultimate aim is to develop a new type of sensor to reduce death from sepsis and MODS, leading to significant reductions in mortality and shorter stays in intensive care.