As COVID-19 spread worldwide in early 2020, the avalanche of patients who needed access to intensive care units (ICUs) suddenly entered the health care systems.
Approximately 10% of hospitalized COVID-19 patients were admitted to these ICUs in the first wave, and most of them required aggressive mechanical ventilation (IMV) due to respiratory failure. In fact, mortality among patients requiring this procedure was very high, ranging from 35 to 50%.
One of the main features of the disease is the damage in the blood vessels, not only in the lungs, but also in other organs. This causes strokes, kidney failure or heart injury. Such organ damage could be responsible for evolution towards multiple organ disorders and, ultimately, the death of the patient.
Monitoring and management of chronic respiratory failure and hemodynamics, blood flow in the body, are essential in the ICU.
Knowing this, and based on their proven knowledge, the team of scientists led by ICREA Prof. at ICFO Turgut Durduran believes the technology could be developed by ICFO’s Medical Optics group, in collaboration with colleagues from Politecnico di Milano and HemoPhotonics. modified and implemented to improve COVID-19 patient management in ICUn.
VASCOVID was conceptualized based on these observations. The aim of the project is to develop a portable, non-invasive, cost-effective and real-time platform for monitoring the microbiological health (microvessels health) of COVID-19 patients in ICUn. This, in turn, would help clinicians in personalizing patient treatments.
The platform combines two near-infrared light-based bio-photonics technologies. Near-infrared light is emitted through a patient’s palm, travels deep (> 1 cm) into the tissue, interacts with the blood in the microvessels and receives information about patients’ blood flow and oxygenation. COVID-19.
The platform is expected to have a high impact on the management of COVID-19 patients at the ICUs. The platform will also be useful for a wider range of patients such as those suffering from sepsis and severe respiratory distress syndrome.
The primary goal is personalization of patient management based on biomarkers derived from the evaluation of microbiological health and endothelial function.
In addition to the prognostic value of the degree of endothelial impairment caused by the disease, the technology provides biomarkers to assess heart-lung interactions, helping clinicians to personally manage pre-existing disease. -Ventilation devices to avoid ventilation-induced lung injury, or the willingness of the screen to move away from the mechanical ventilator, the final stage of respiratory support, which often fails due to lack of cardiovascular.
Coordinated by ICREA Prof. ICFO Turgut Durduran has seven European partners: ICFO, Consorci Corporacio Sanitaria Parc Tauli de Sabadell, Politecnico di Milano (POLIMI), and the companies HemoPhotonics, BioPixs Limited, Splendo Consulting BV and Asphalion.
We have been working with this technology using near-infrared light for more than a decade in projects related to neuro-examination, cancer screening and others. We were able to use our expertise in these applications at hospitals around the world to quickly adapt to the needs of COVID-19 management and propose this new platform.
Turgut Durduran, ICREA Professor, ICFO-Photonis Institute of Sciences
Dr. Davide Contini, from Politecnico di Milano, continues “We are challenged to complete this project in the near future, but we are confident that we will achieve this goal. We also note that COVID-19 will stop the dramatic advances in vaccines but this technology will apply to many patient groups at the ICUs as well as prepare us for such pandemics. this is in the future “. Durduran concludes that” protective healthcare in the future is one important lesson we have learned from the pandemic. “
Dr Jaume Mesquida, an intensive carer from CS Parc Taulide Sabadell, confirms “This is a great opportunity in the evolution of ICU research towards non-invasive technologies. Its features, such as wireless and portable, make it a unique device. for these units. We hope to use this tool on as many patients as possible to measure effectiveness and see if the information we receive could be translated into a parameter that will help us make decisions. “
The view of the VASCOVID platform
The platform is expected to have a high impact on the management of COVID-19 patients as well as a wide range of others such as those with sepsis and severe respiratory distress syndrome. It is intended to be all-inclusive and automated with the additional components necessary to be practical and useful in ICUs. Finally, it will be an important enabling tool for large-scale testing of new therapies and therapies aimed at addressing microbiological impairment and reducing deficiency failure of ICU patients withdrawing from ventilation. mechanical.
Light and microvessels
The noninvasive method used by VASCOVID combines two bio-photonics technologies, near-infrared spectroscopy (TR-NIRS) and diffuse correlation spectroscopy (DCS). The device uses light to penetrate deep (> 1 cm) into the palm of the patient’s hand, reach the micro-vessels and measure specific variables such as oxygenated and deoxidized hemoglobin concentrations and blood flow. .
The device also incorporates an automated tourniquet to bring a period of ischemia to the palm by injecting the tourniquet above arterial blood pressure. The response of the microvasculature to such a challenge is known to be indicative of both microbiological and endothelial health.
Now, why the palm of the hand? In diagnostic care, peripheral figs were used as a window for evaluating the status of global organ movement. This approach relies on the fact that non-essential marginal areas are the first to be sacrificed in conditions of cardiovascular insufficiency.
For this reason, previous clinical studies have confirmed that patients ’palm microvessels provide a complete view of what is happening in our bodies. In fact, if the micro-vessels in the palm are not working properly, this means that our body in general is not working properly and there may be a great deal of danger ahead.
Source:
ICFO-Institute of Photonic Sciences