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City's Biomedical Engineering Research Group (BERG) secures over £1.5m funding

Professor Panicos Kyriacou to spearhead innovative technologies to improve the lives of people suffering with Bipolar disorder and facilitate the early detection of Multiple Organ Dysfunction Syndrome (MODS).
by John Stevenson

City University London's Biomedical Research Group in the School of Engineering and Mathematical Sciences, led by principal investigator Professor Panicos Kyriacou, has recently secured funding from the National Institute of Health Research (NIHR) Invention for Innovation (i4i) scheme for two projects totalling £1,554,894.

The funding will allow for the development of a multi-parameter esophageal sensor for the early detection of Multiple Organ Dysfunction Syndrome (MODS). This project will take place over three years. The second project involves the development of a Personal Lithium Blood Level Analyser for patients with Bipolar mood disorder. Funding for the lithium analyser is subject to successful completion and approval of a pilot study.

The co-investigators on these projects are City's Dr Justin Phillips, Dr Ioasonas Triantis and Dr Michelle Hickey as well as Professor Richard Langford and Dr Eleni Palazidou of St Bartholomew's Hospital.

Personal Lithium Blood Level Analyser for patients with Bipolar disorder:

nullBipolar disorder is a serious life-long condition, characterised by recurrent episodes of depressed and manic mood states which impair the lives of those affected.

Approximately one to two per cent of the UK population has been diagnosed with bipolar disorder, often developing between the ages of 18 and 24 years. Lithium is the most widely used medication for treating bipolar disorder and is highly effective at controlling mood swings, preventing further episodes and reducing suicide risk.

However, concentrations of the drug require regular monitoring given its effectiveness within only a narrow therapeutic range; at higher levels it has serious toxic effects which are potentially dangerous for patients. Toxic blood lithium levels can cause circulatory failure, kidney damage, seizures, coma and death.

The National Institute for Health and Clinical Excellence (NICE) guidelines recommend that blood lithium levels should be checked at three-month intervals once stable. Currently, patients need to attend a clinic to have their blood checked. It is recognised that in the UK, lithium monitoring falls short of recommended standards.

nullA low-cost, personal health care technology to monitor blood lithium levels at home would improve the patients' sense of involvement in the management of their illness and improve adherence to effective monitoring. It would also make it easier to detect the shift of lithium concentrations outside the therapeutic range. The monitor will employ smart medical optical and electrical sensors to non-invasively monitor changes in blood lithium levels through the skin and will indicate when a laboratory blood test is needed. Such a device is currently unavailable for Bipolar disorder patients.

The development of a multi-parameter oesophageal sensor for the early detection of Multiple Organ Dysfunction Syndrome (MODS):

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 percent of patients admitted to intensive care develop MODS, which is estimated to cause from 47 percent to 80 percent 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 for providing an early indication of inadequate oxygen supply in abdominal organ tissues. Patients undergoing major surgery or in the ICU routinely have tubes or probes inserted into the gullet for the purposes of feeding, temperature measurement and other monitoring.

Glucose MeterThis work proposes the use of 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 in ICU patients, following informed, written consent.

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.

Professor Kyriacou is pleased with the NIHR funding of the projects and views this as a significant achievement for biomedical engineering at City:

"I am delighted that both projects were successful in such a competitive process. Clearly, this is a major achievement for the Biomedical Engineering Research Group (BERG) at SEMS, confirming our commitment and expertise in the area of health care technologies. Both proposals will deliver unique technological solutions in healthcare, one for intensive care patients using our long track record and experiences in optical sensors and the other in bipolar patients, an indeed new area of research where currently technologies for assessing patients with mental disorders do not exist."

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