Sep. 30, 2002 PITTSBURGH, Sept. 27 – When treating trauma and critical care patients after severe hemorrhagic shock, hours and days count. That's why University of Pittsburgh researchers, working with an Israeli physiology professor, saw the need to develop a "smart" urinary catheter - which is typically used for bladder drainage – that they modified in order to provide clinicians with immediate information about the amount of oxygen organs are receiving. Results of animal studies and preliminary results of the catheter's use in two patients indicate the device is also less invasive than current techniques. Julio Clavijo, M.D., visiting research associate professor in the division of surgery and critical care medicine at the University of Pittsburgh School of Medicine, presented these findings today at the American Association for the Surgery of Trauma's 2002 Annual Meeting at the Hilton at Lake Buena Vista in Orlando, Fla.
When a patient suffers from hemorrhagic shock, the massive loss of blood greatly reduces the amount of oxygen delivered to all organs, which can result in organ damage. Current monitoring techniques to assess oxygen delivery in trauma patients are often invasive and not always applicable in the clinical setting.
"By developing better ways to monitor trauma and critical care patients in the intensive care unit we can implement timely decisions regarding their care," said Juan Carlos Puyana, M.D., F.A.C.S., associate professor of surgery and critical care medicine at the University of Pittsburgh School of Medicine and senior author of the study.
The investigators constructed a urinary catheter with a fluorescent-based fiber optic probe that directly measures blood flow and oxygen utilization. This fiber optic probe is of the same type used by neurosurgeons and anesthesiologists to measure oxygen utilization in the brain.
In animal studies of the catheter, the researchers found that during hemorrhage, changes in blood flow and oxygen delivery to the urethra were correlated. These findings suggest that such information about the clinical status of trauma patients could be collected in a more timely basis and monitored by this less invasive means.
"We hope by using technology such as this we can begin to learn more about the mechanisms of trauma and associated organ failure so we can begin to formulate better outcomes for these patients," added Dr. Puyana.
James van Bastelarr, M.D., a medical student at the University of Groningen in the Netherlands, and Avraham Mayevsky, Ph.D., professor of physiology at Bar Ilan University in Ramat Gan Israel were co-authors of this study.
In addition to his appointment at the University of Pittsburgh School of Medicine, Dr. Puyana is also a trauma surgeon at the UPMC Presbyterian Trauma Center, where more than 3,000 patients are treated each year. Since 1987, it has been accredited as a Level I trauma center, the highest certification possible, by the Pennsylvania Trauma Systems Foundation.
Funding for this study was provided by the U.S. Army Medical Research Command through a grant to the Center for Innovation in Minimally Invasive Therapies in Boston.
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