Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
Adv Sci (Weinh). 2021 Dec;8(24):e2102861. doi: 10.1002/advs.202102861. Epub 2021 Oct 28.
Continuous monitoring in the intensive care setting has transformed the capacity to rapidly respond with interventions for patients in extremis. Noninvasive monitoring has generally been limited to transdermal or intravascular systems coupled to transducers including oxygen saturation or pressure. Here it is hypothesized that gastric fluid (GF) and gases, accessible through nasogastric (NG) tubes, commonly found in intensive care settings, can provide continuous access to a broad range of biomarkers. A broad characterization of biomarkers in swine GF coupled to time-matched serum is conducted . The relationship and kinetics of GF-derived analyte level dynamics is established by correlating these to serum levels in an acute renal failure and an inducible stress model performed in swine. The ability to monitor ketone levels and an inhaled anaesthetic agent (isoflurane) in vivo is demonstrated with novel NG-compatible sensor systems in swine. Gastric access remains a main stay in the care of the critically ill patient, and here the potential is established to harness this establishes route for analyte evaluation for clinical management.
在重症监护环境中进行连续监测,改变了对处于危急状态的患者进行干预的能力。非侵入性监测通常仅限于经皮或血管内系统与传感器结合使用,包括氧饱和度或压力。在这里,假设通过鼻胃管(NG 管)可以获得胃内液体(GF)和气体,这在重症监护环境中很常见,可以提供对广泛生物标志物的连续访问。对猪 GF 中的生物标志物进行了广泛的表征,并与时间匹配的血清进行了结合。通过将这些与急性肾衰竭和猪中诱导应激模型中的血清水平相关联,建立了 GF 衍生分析物水平动力学的关系和动力学。通过在猪中使用新型与 NG 兼容的传感器系统,展示了监测酮水平和吸入麻醉剂(异氟烷)的能力。胃内进入仍然是危重病患者护理的主要方法,这里建立了利用这条途径评估分析物以进行临床管理的潜力。