Cardiac output, Oxygen delivery & Microcirculation in MediCAL patients
Research type
Research Study
Full title
Non-invasive Cardiac output, Oxygen delivery and sub-lingual Micro-circulation as a predictive tool in acute MediCAL admission patients - COM-MICAL study
IRAS ID
204395
Contact name
James Doyle
Contact email
Sponsor organisation
Royal Surrey County Hospital
ISRCTN Number
ISRCTN82077534
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Early identification of patients who may need admission to an intensive care unit (ICU) is currently the top research priority of the James Lind Alliance Priority Setting Partnership for Intensive Care. Predicting which patients are likely to deteriorate (and who may subsequently need admission to an ICU) is extremely challenging. Only relatively basic monitoring or investigations are usually performed on patients admitted to medical admission units (from the emergency department or via general practitioners). There have been no published studies looking at cardiac output, oxygen delivery and markers of microcirculatory function in newly-admitted medical patients. It is known that 'standard' monitoring (eg blood pressure, heart rate, respiratory rate and oxygen saturations), usually recorded on a National Early Warning System chart (NEWS) is not good at predicting deterioration, outcomes or need for intensive care. We hypothesise that by non-invasively monitoring variables usually only utilised within a theatre or intensive care environment, we may build a more comprehensive and timely picture of a patients physiology. This could subsequently be used as a tool to identify ill patients more rapidly and may also be useful for investigating benefit from intensive care. By looking at the patients journey subsequent to admission, we may find important associations between initial (early) physiology and subsequent outcome. We plan to look at cardiac output, microcirculatory status, oxygen delivery and markers of acute kidney injury. We will also review hospital outcome, patient NEWS scores, admissions to ICU and basic demographics of patients. Cardiac output has already been shown to be useful in early differentiation of cause of breathlessness in the emergency department and this study is also likely to be of interest to physicians at the early stage of diagnosing acute medical patients.
REC name
Wales REC 7
REC reference
16/WA/0298
Date of REC Opinion
18 Nov 2016
REC opinion
Further Information Favourable Opinion