Sensing using Neutrophil Activation Probe on ITU
Research type
Research Study
Full title
Sensing using Neutrophil Activation Probe on the Intensive Therapy Unit
IRAS ID
193355
Contact name
Kev Dhaliwal
Contact email
Eudract number
2015-005676-25
Duration of Study in the UK
2 years, 1 months, 4 days
Research summary
Summary of Research
This study aims to investigate the utility of a novel test of lung inflammation to be used in the intensive care unit (ICU) to help predict the likelihood of lungs getting better or worse whilst on a ventilator. Critically ill patients often succumb to acute lung inflammation, which can be brought about by a wide range of trigger conditions. The lungs are the commonest organ to fail and require support in the intensive care environment. No methods exist that can be used at the bedside to immediately tell us what biological processes are causing the deterioration in a person’s lungs. When trying to accurately diagnose and classify these lung diseases there is a risk that the type of respiratory disease is misdiagnosed, missed or the level of severity is not captured. The new test we are investigating involves spraying tiny doses (micro doses) of a chemical smart probe directly into the deep part lungs, which lights up upon contact with a specific type of inflammatory cell. This optical signal is detected by special fibered microscope. Both are passed through the breathing tube used to maintain mechanical ventilation without interrupting it. Participants are eligible to be enrolled if they are mechanically ventilated and are predicted to require ventilation for at least 2 days. The study is being conducted in Edinburgh adult ICU units. Each participant will undergo at least one but up to three test procedures during the course of seven days, provided they continue to require ventilation. Participants will be asked to provide blood samples and may be asked to provide lung washings. After this period there will be no further direct contact between the investigation team and the participant. The test will not inform clinical decisions. The study is being supported by the Medical Research Council.Summary of Results
The SNAP-IT study was designed to investigate the utility of a novel test of lung inflammation to be used in the intensive care unit (ICU) to help predict the likelihood of lungs getting better or worse whilst on a ventilator. The study involved spraying tiny doses (micro doses) of a fluorescent chemical smart probe NAP (neutrophil Activation Probe) directly into the deep areas of the lungs during a bronchoscopy on mechanically ventilated patients. This probe lights up upon contact with a specific type of inflammatory cell which could then be imaged using a fibre based microscope.Our initial goal was to enrol 75 participants into the study but unfortunately, the study ended early due to the global COVID-19 pandemic. We successfully performed the procedure on 11 participants. In the absence of a true reference standard for neutrophilic inflammation in the alveolar space, the primary objective of the study was to determine the reliability of NAP signal during multiple transbronchial passes of the same segment in the same patient. Amongst 11 patients of a planned 75 patient study, the statistics indicate moderate to good reliability, but caution is needed due to the small sample size.
REC name
Scotland A: Adults with Incapacity only
REC reference
16/SS/0052
Date of REC Opinion
27 May 2016
REC opinion
Further Information Favourable Opinion