Problem Statement
Sepsis, a complication of the body's immune response to an infection, can quickly become life-threatening if left untreated or if there is a delay in appropriate treatment. According to the Sepsis Alliance, over 250,000 people every year die of sepsis in the U.S., and the speed with which sepsis can end a life is startling - within days of first symptoms, sepsis can begin shutting down organs and body functions. even for those who survive, chronic pain, hearing or vision loss and amputations can be lasting effects of a condition that is alarmingly common and easily treatable, yet often undetected.
Part of the challenge is that, taken into account individually, the constellation of symptoms of a patient who is septic or is on their way to becoming septic is not necessarily indicative of sepsis. Patients and medical professionals alike often do not recognize the signs of sepsis, and unfortunately, by the time tit becomes clear that a patient is septic, the situation is critical and a life is at risk.
Solution
Monitor changes in blood profusion
Detect Mottling/changes in heterogeneity
How we do it - Use a matrix of optical sensor
Future goals - use optical sensors to monitor heart rate, blood pressure, respiratory rate
Constraints - patients get turned every 2 hours
Prototype X1
Prototype X3
Prototype X4
Repeatability Procedure
Objective: Patches
of discolored skin
is a symptom
of sepsis. This research
project seeks to investigate whether
a 50x50 patch of photo-transistors can be used to monitor cumulative
changes in skin perfusion. Sepsis
occurs when bacteria in the bloodstream triggers an inflammatory response
throughout the body. As the infected bloodstream worsens, blood flows away from
the skin, towards vital organs. This
project consists of three objectives: 1)
Build a 50x50 photo-transistor patch
capable of finding the average perfusion across the skin; 2) Demonstrate that the patch of photo-transistors
can be used to detect surface perfusion and mottling. Do this by performing a tourniquet test: Use the patch to take measurements of skin
perfusion, while a tourniquet is applied.
Then, release the tourniquet and use the patch to take more measurements
of skin perfusion. Compare the
cumulative changes in skin perfusion. We
can tell that the patch is working if we see a positive change in skin
perfusion when the tourniquet is released;
3) Perform pilot study for detecting sepsis recovery. Measure skin perfusion during sepsis and see
if we can detect positive blood perfusion during sepsis recovery. Please reference
the attached sheet for information on a relevant clinical trial in HUP’s MICU.
Scope: The following items are
within the scope of this project: 1) Develop a 50x50 patch of sensors for
monitoring blood perfusion, near the surface of the skin. A patch is used because we need lots of data
across the surface of the skin; 2) Shine light into the patient's skin
and analyze the
reflection to gather blood volume data; 3) Use green LEDs when gathering
patient data. Green light minimizes the depth of photon penetration, and is
therefore optimal for gathering data, near the surface of the skin; 4) Use the
patch to measure skin perfusion while a tourniquet is, and is not, applied; 5) Perform
pilot study on patients within HUP's MICU.
Please reference the attached sheet for information on a relevant
clinical trial in HUP's MICU. I have been working with Dr. Barry Fuchs to set
the up the trial. 6) Evaluate whether or not we see less perfusion under
mottling.
Outline: The outline of my
research paper would be as follows: 1) Briefly explain the design &
function of a single sensor. This sensor
shines green light & measures the reflection. Explain how the output data of this sensor relates to blood perfusion,
near the surface of the skin; 2) Present the signal processing methodology used
to analyze data, from a 50x50 matrix of photo-transistors, to monitor changes
in cumulative skin perfusion, over time; 3) Describe the pilot study conducted
with Dr. Barry Fuchs, please reference the attached sheet for information on a
relevant clinical trial in HUP's MICU;
4) Present conclusions on the effectiveness of using a
matrix of 50x50 photo-transistors to monitor cumulative changes in skin
perfusion.
Fig. 3 – Discolored
skin during sepsis.2
Symptoms of Sepsis
|
How
Healthcare Professionals
Diagnose Sepsis
|
Issues with Current
Diagnosing Methods
|
Elevated heart rate
(tachycardia),
|
Clinically, the patient needs to fit at
|
Most
sepsis patients
|
fever, low body
temperature
|
least two of the diagnostic criteria
|
are recovering from
|
(hypothermia), a reduced carbon
|
listed here and have a suspected or
|
surgery. So many
|
dioxide (PaCO2) level
in the blood,
|
proven infection. This is a screening
|
monitoring devices
|
chills, dizziness, fatigue, shivering,
|
tool to help
healthcare professionals
|
already reflect that the
|
facial flushing, shortness
of
|
presumptively diagnose sepsis early in
|
patient is in poor
|
breath, low
urine production, skin
|
the disease process. Definitive
|
condition. It is
difficult
|
discoloration, dysfunction of one
|
diagnosis depends on
a positive blood
|
to see through that &
|
or more organs, shock, and
|
culture for an
infectious agent and
at
|
see that the patient is
|
sleepiness.
|
least two of the criteria.3
|
becoming septic.
|
 |
2 https://healthrave.org/skin/mottled‐skin‐meaning‐pictures‐before‐death‐in‐babies/
Objective: Livedo reticularis (mottling) is a symptom of sepsis, especially
on top of the knee (reference Figure 1).
This research project seeks to
investigate whether monitoring the blood volume near the surface of the skin can
be used for earlier detection of sepsis. This project consists of four basic
objectives: 1) Develop a matrix of photo-sensors; 2) Develop a device which uses this matrix
of sensors to gather blood volume data (near the skin); 3) Use this device to test whether or not
blood volume changes can be seen in healthy patients with restricted blood flow
(i.e. when a tourniquet is applied to a healthy person); 4) Use this device to gather data on ten
patients within HUP’s MICU as part of a pilot study; 5) Analyze patient data to
determine the device’s capacity to monitor changes in
blood volume as an indicator of sepsis
recovery/deterioration.
Figure 1 – Mottled reticulated
vascular pattern that appears as a lattice-like purple discoloration of the
skin. This discoloration is caused by
swelling of the venules owing to obstruction of capillaries by small blood
clots. Image taken of patient in HUP’s
MICU, via Dr. Barry Fuchs.
Scope: The following items lie
within the scope of this project: 1) Construct a matrix of photo-sensors and
green LEDs; 2) Shine
light into patient's
skin and analyze
the reflection to gather data
over a 4”x4” surface area; 3) Use the device to gather data on ten patients
within HUP's MICU; 4) Perform signal
processing to determine if data from optical sensor array can be used to detect
vital signs (blood surface profusion, changes in heart rate, respiratory rate,
blood pressure, etc.).
Outline: The outline of my
research paper would be as follows: 1) Briefly explain the design &
function of a single sensor. Explain how the output data of this sensor relates to blood volume near
the surface of the skin; 2) Present the signal processing methodology used to
analyze data, from a matrix of photo-sensors, to monitor changes in blood
volume/distribution, over time; 3) Describe the pilot study conducted within
HUP’s MICU; 4) Present conclusions on
the effectiveness of using blood volume data (near the surface of the skin) to
detect the onset of sepsis; 5) Describe
how the device might be refined to yield superior results.
SETUP
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