Each year in the UK, more than 24,000 people are
admitted to Intensive Care with critical respiratory illnesses
including pneumonia, asthma and chronic obstructive pulmonary
disease (COPD). This equates to 10 per cent of yearly Intensive
Care Unit (ICU) admissions, and mortalities for these conditions
are high at 10 per cent, 40 per cent, and 50 per cent,
respectively.
At Guy's and St Thomas' NHS Foundation Trust, rates of
respiratory critical illness are even higher, accounting for 20 per
cent of all ICU admissions annually. Physiological deterioration
precedes hospital admission yet often goes undetected, however
earlier detection could result in more timely clinical
intervention, improving patient outcomes and reducing healthcare
costs.
In response, the King's Health Partners Clinical Respiratory
Physiology Group with the Department of Medical Physics from Guy's
and St Thomas' has developed 'Myotrace': a monitoring device that
detects early signs of deterioration in COPD patients by measuring
an advanced physiological biomarker called neural respiratory
drive. 'Myotrace' can also be used to predict hospital
re-admission.
'Myotrace' is a virtual blackbox solution that uses electrodes
to measure the performance of the parasternal intercostal muscles
when patients breathe, as well as relevant biomarkers such as
respiratory and heart rates. It also collects, processes, and
analyses the resulting data.
With an earlier pilot study of the technology with £25,000
funded by Guy's and St Thomas' Charity Innovation Fund for
Technology Transfer scheme yielding promising results, a research
grant of £159,569 was awarded to the team in 2009 to further
evaluate the effectiveness of the technology.
The Myotrace project is currently recruiting patients for this
next validation phase, with the software under development to
create a user-friendly interface and hardware. Once these two steps
are complete, the plan is to test Myotrace on a wider basis through
a number of centres and in the home setting, with a view to
developing the tool for the commercial market.
The clinical academic lead for the 'Myotrace' project, Dr
Nicholas Hart, commented 'This technology could potentially not
only be useful in the hospital for the early identification of
treatment failure in COPD, but also be used to predict re-admission
within 28 days, which is now an important NHS strategic
target. Furthermore, by our close collaboration with Philips,
we are planning to test 'Myotrace' in the home setting to identify
clinical deterioration early which fits with the e-health
management programmes that are being developed'.
The initiative reflects the Charity's commitment towards
supporting innovation in healthcare which will benefit patients at
Guy's and St Thomas' but with the potential for wider application
across the health service.