ECONOMIC
Research type
Research Study
Full title
Evaluation of COlour flow Observation of the Microcirculation In Children (ECONOMIC)
IRAS ID
161087
Contact name
Enitan D Carrol
Contact email
Sponsor organisation
The University of Liverpool
Duration of Study in the UK
0 years, 2 months, 19 days
Research summary
Sepsis is the response of the body to bacterial infection. In children in the UK, it has a mortality of 10%; with long-term consequences for many survivors.
A major problem in sepsis is the loss of perfusion (blood supply in small blood vessels) to vital organs like the brain, kidneys and lungs.
Fluids and drugs are used to support perfusion; these drugs are called vasoactive drugs. Individuals respond to vasoactive drugs differently. Rapidly finding the right combination and dose of vasoactive drugs is important to maximize benefit and minimize potential side effects.
Currently on the Paediatric Intensive Care Unit (PICU) the dose and combination of vasoactive drugs is guided by bedside measurements, such as blood pressure and oxygen saturation, which we know are poor indicators of organ perfusion.
It is possible to assess the small blood vessels (or microcirculation) where nutrient exchanges takes place, using a hand-held device placed on the side of the mouth: this is called side-stream dark field imaging (SDF). Previously analysis of the images from SDF was done manually, using a tedious scoring process which was slow, limiting the use of SDF in a clinical setting to guide alterations in therapy.
‘Colour-mapping’ Software has been developed at the University of Liverpool (http://www.liv.ac.uk/~sdb/MIASMA) which analyses the data in minutes and may enable the use of SDF to individualise treatment for critically ill children on PICU.
Our eventual intention is to study whether SDF-guided management improves patient outcome in sepsis. We first need to evaluate colour-mapping software in a real-life environment, as to-date it has only been validated in controlled conditions; this is the major objective of this study.
Children admitted to PICU with sepsis will be recruited for this observational study where we will use SDF to monitor their microcirculation in response to normal treatment over time.REC name
North West - Liverpool Central Research Ethics Committee
REC reference
14/NW/1406
Date of REC Opinion
10 Nov 2014
REC opinion
Favourable Opinion