CLINICIP

 “Closed Loop Insulin Infusion for Critically Ill Patients"

CLINICIPis an European FP6 Integrated Project with the objective to develop a glucose monitoring and control system for critically ill patients.

Role: Partner

Activity period: 2004-2007

Research Line: Biophotonic diagnostics

Diagnostics at hospitals have been, in most cases, based on conventional analytical techniques, or ELISA techniques based on bioassays which are not suitable for bedside or emergency room. In the last decade to some extent the analytical resources of small hospitals have been closed as well as labs have been centralised. In parallel many people realised that on the other hand an urgent need resulted regarding acute diagnostics and emergency medicine. This Integrated Project (IP) intended to achieve a validated, intelligent, fully automated diagnostic device with a modular system based on biosensor technology, combining successful transduction principles, biochemical recognition methods and communication capabilities. By these means, CARE-MAN had a long-term objective to overcome above mentioned restrictions and had the main aim to develop new medical instrumentation for the future and giving a potential of down-scaling to be used in general practices and a vision to provide new automated self-controlled equipment for patient home-care. Thus, CARE-MAN's intension can be stated to cover needs in emergency medicine as well as in case of post-operative checks or for permanent surveillance in case of chronic diseases.

Healthy people can develop a typical physiological symptoms under critically ill conditions, e.g. in the intensive care unit (ICU). Due to shock and trauma as a consequence of the surgery, the glucose concentration is likely to rise significantly comparable to the symptoms known as insulin-dependent Diabetes Mellitus. Similar to diabetes mellitus, the high glucose level needs to be treated with external insulin. According to a study in Belgium the intensive insulin therapy treatment cuts the mortality rates by 42% compared to standard insulin therapy for ICU indication.

The project, coordinated by Joanneum Research had the objective to provide an intelligent system for improved health status monitoring of critically ill patients. A local system was developed comprising biosensors for the determination of glucose in whole blood. Based on the continuous measurement, an adaptive control algorithm generates advice and thus represents a decision supporting system in an early project stage. Within a closed loop system intensified insulin treatment will make use of calculation results leading to the external regulation of glucose. In addition to the approach of controlling the glucose concentration, a minimally invasive treatment was also investigated. A number of biosensors for the determination of most important parameters such as lactate, carbon dioxide, oxygen and pH was developed to characterize adipose tissue. In order to support the implementation of intensified treatment in an optimal way, a telemedical infrastructure was also estdeveloped.

Within this project the Chemical and Biochemical Optical Sensor Group was responsible of the Workpackage “Metabolite Sensors” focused on the measurement of pH, pO2, pCO2 and lactate in the adipose tissue and its research activity was manly focused in the development of an optical fibre pH sensor coupled to the microdialysis circuit and capable to measure the pH of the dialysate.

More information on the project at: http://cordis.europa.eu/project/rcn/71227_en.html