As hospitals continue to struggle with sepsis, a leading cause of death and costly patient readmissions, a rapid and accurate point-of-care device has the potential to help physicians better diagnose this serious medical condition caused by an overwhelming immune response to infection.
A team of researchers from the University of Illinois and physicians at the Carle Foundation Hospital in Urbana, Ill., have completed a clinical study of the sepsis lab-on-a-chip, which counts white blood cells and levels of a protein marker called CD64, which surge as a patient’s immune response increases.
“By measuring the CD64 and the white cell counts, we were able to correlate the diagnosis and progress of the patient—whether they were improving or not,” says Umer Hassan, a postdoctoral researcher at Illinois and the first author of a study published earlier this month in the journal Nature Communications.
Typically, sepsis is detected by monitoring patients’ vital signs. Nonetheless, researchers were able to monitor white blood counts and CD64 levels over time, correlating them with the patients’ vital signs. In addition, researchers have demonstrated the biochip’s utility for improved sepsis diagnosis by combining these measurements with an electronic health record.
“By quantifying these two parameters, we can diagnose sepsis without relying on those non-specific vital signs,” contends Hassan, who says the test takes about 30 minutes to complete but there are plans to reduce it to five minutes.
Diagnosing sepsis early is critical to increasing patients’ chances of survival from the deadly disease using several innovative treatments, including antimicrobial, immune-stimulating and immunosuppressive therapies, according to the authors.
Further, they contend that as value-based payment takes hold in healthcare, hospital reimbursement will be “based on showing steady improvement over time in critical statistics, including lengths of stay, mortality rates, rates of hospital-acquired infections and many others.”
Severe sepsis strikes more than a million Americans annually, including about 20 percent of all ICU patients, with an overall cost of about $24 billion to the healthcare system. And, between 28 percent and 50 percent of these patients die.
“A more specific and sensitive method to perform accurate stratification of sepsis will not only improve patient outcomes but will be a critical part of the financial survival of hospitals across the United States,” the article states.
“We hope that this technology will be able to not only diagnose the patient but also provide a prognosis,” adds Hassan. “We have more work to do on that.”
For now, however, Hassan and his colleagues believe that the biochip can potentially be used at the patient’s bedside by drawing a small drop of blood for continuous monitoring of their immune system in response to various therapeutic interventions at different stages of sepsis. Researchers tested the device with blood samples from patients in Carle Foundation Hospital’s ICU and emergency room.
Ultimately, the research team—led by Rashid Bashir, a professor of bioengineering at the University of Illinois and the interim vice dean of the Carle Illinois College of Medicine—want to commercialize their device. A startup company—called Prenosis, where Bashir serves as chief scientist—has been launched for that purpose, according to Hassan, who adds that they are working with commercial partners.
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