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用于识别急性上消化道出血的遥测胃传感器的临床前研究:“HemoPill 监测器”。

Pre-clinical study on a telemetric gastric sensor for recognition of acute upper gastrointestinal bleeding: the "HemoPill monitor".

机构信息

Ovesco Endoscopy AG, Tuebingen, Germany.

Eberhard Karls Universitaet Tuebingen, Tuebingen, Germany.

出版信息

Surg Endosc. 2020 Feb;34(2):888-898. doi: 10.1007/s00464-019-06845-4. Epub 2019 May 28.

Abstract

BACKGROUND

Acute upper gastrointestinal bleeding is a life-threatening medical condition with a relevant risk of re-bleeding even after initial endoscopic hemostasis. The implantable HemoPill monitor contains a novel telemetric sensor to optically detect blood in the stomach allowing the surveillance of high-risk patients for re-bleedings.

METHODS

In this pre-clinical porcine study, bleeding has been simulated by injecting porcine blood into the stomach of a pig through an implanted catheter using a syringe pump. The effect of the sensor position in the stomach, the gastric food content, and the bleeding intensity was investigated.

RESULTS

Sensitivity and specificity of the sensor reached more than 87.5% when the sensor was positioned close to the source of bleeding. Solid food had a higher negative impact on sensitivity than liquid food but a positive impact on specificity. A heavy bleeding was more likely to be detected by the sensor but was also associated with a lower likelihood for true-negative results than weaker bleedings.

CONCLUSIONS

The study clearly demonstrated the capability of the HemoPill sensor prototype to detect clinically relevant bleedings with high sensitivity and specificity (> 80%) when the sensor was positioned close to the bleeding site. The sensors proved to be robust against artefact effects from stomach content. These are favorable findings that underline the potential benefit for the use of the HemoPill sensor in monitoring patients with a risk of re-bleeding in the upper gastrointestinal tract.

摘要

背景

急性上消化道出血是一种危及生命的医疗状况,即使在初始内镜止血后,仍存在再次出血的相关风险。植入式 HemoPill 监测器包含一种新型遥测传感器,可通过光学检测胃中的血液,从而监测有再次出血风险的高危患者。

方法

在这项临床前猪研究中,通过注射器泵将猪血注入猪的胃中,通过植入的导管模拟出血。研究了传感器在胃中的位置、胃内食物含量和出血强度对传感器的影响。

结果

当传感器靠近出血源时,传感器的灵敏度和特异性均超过 87.5%。固体食物对灵敏度的负面影响高于液体食物,但对特异性有积极影响。较重的出血更有可能被传感器检测到,但与较弱的出血相比,其真阴性结果的可能性较低。

结论

该研究清楚地表明,当传感器靠近出血部位时,HemoPill 传感器原型具有检测临床相关出血的高灵敏度和特异性(>80%)的能力。传感器对来自胃内容物的伪影影响具有较强的抗干扰能力。这些有利的发现强调了在监测上消化道再次出血风险患者时使用 HemoPill 传感器的潜在益处。

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