Project: The COMET Monitor for clinical information on Cellular Oxygen Metabolism

Patient monitoring is vital for successful treatment of patients. Advances in patient monitoring technology introduced since the 1980ies brought various measurements of oxygen supply to tissue. Rather than adding another measure of oxygen SUPPLY, the cellular monitor developed by Photonics Healthcare permits the direct measurement of CONSUMPTION of oxygen (mitochondrial respiration) i.e., the production of energy in our cells. This lets doctors look 'under the hood' to directly check the functioning of the engine of life rather than its fuel supply. Inadequate oxygen supply and cellular dysfunction have common symptoms but require different treatments, so doctors need a monitor to make the distinction. In recent months the long suspected cellular dysfunction in critical illness could be measured directly for the first time. Not only oxygen supply to tissues is impaired, critical illness reduces oxygen consumption by tissue cells even when oxygen availability is restored by therapy. These measurements demonstrate the utility of the COMET Monitor and its immediate relevance for guiding therapy. The direct measurement of cellular oxygen metabolism opens the door to the development of better treatments for many conditions including critically illness, cancer, trauma, diabetes and the healing of burns and wounds and allows the assessment of tissue viability with a single device. The project aims to quickly bring a reliable and sensitive monitor with a newly developed light source to the market. This will enable clinical trials that open large clinical markets and change the standard of care in hospitals all over the world._x000D__x000D_The leading cause of death in intensive care units, blood poisoning (sepsis), exemplifies the above. Severe sepsis is an expensive, and frequently fatal condition. Despite the full effort of modern medicine about half of the patients with advanced stages of sepsis die. The current COstay of therapy is administration of antibiotics and early goal directed fluid therapy. While fluid therapy in early stages of sepsis might be beneficial, in later stages it may become detrimental (Fig 2&3). In clinical practice it is difficult to determine the stage of sepsis in a patient at the time of presentation and impossible to distinguish between a problem of oxygen supply and oxygen consumption. Because of the causal relationship between cellular metabolic dysfunction with organ failure and outcome, better treatments require the measurement of oxygen metabolism. Therapies directed at improving hemodynamics and oxygen supply likely add to the deterioration in cellular metabolism if applied inadequately. Monitoring modalities for cellular metabolism are needed to get out of this vicious and deadly cycle.(Fig 4)_x000D__x000D_SOLUTION_x000D_In this project we develop the COMET Monitor, the first system to monitor Cellular Oxygen METabolism. It works non-invasively and directly at the bed of the patient and optically measures mitochondrial oxygen consumption, availability and affinity based on a patent protected invention. This provides direct and quantitative information about essential cellular metabolism that turns food and nutrients into energy. The COMET Monitor enables better treatments by providing physicians with long desired information about what really matters for survival: cellular viability and function._x000D_ _x000D_MARKET_x000D_The project aims to quickly bring a reliable and sensitive monitor to the market. This will enable clinical trials that open large clinical markets and change the standard of care in hospitals all over the world. Clinical customers will be intensive care units, motivated by the ability to improve outcomes. Every year sepsis affects about 18 million patients globally, more than half a million people die in the EU & US alone. Monitoring cellular oxygen metabolism in the critically ill will provide essential information for personalized treatments. It will enable intensive care physicians to better select treatments, control nutrition and drug administration, to optimize oxygenation and to establish prognosis. The COMET Monitor is a much needed tool to save lives and cut treatment cost._x000D__x000D_STEPS_x000D_This EuroStars project combines the complementary expertise of two very different companies and one academic medical center. We intend to show that a scientific breakthrough that is currently too expensive and cumbersome for clinical use can become a commercially viable system. Vital steps will be the development of a novel laser and automated measurement head plus software. The developed COMET Monitor will widely be used in clinical research and is anticipated to transform the standard of care.

Acronym COMET (Reference Number: 7294)
Duration 03/09/2012 - 31/08/2015
Project Topic Millions still die in intensive care units. Critical illness is marked by altered metabolism of our cells, but bedside information about cellular function is not available. The COMET Monitor provides this for the first time, allowing doctors to personalize treatments, to save costs and lives.
Network Eurostars
Call Eurostars Cut-Off 8

Project partner

Number Name Role Country
3 InnoLas Laser GmbH Partner Germany
3 Photonics Healthcare B.V. Coordinator Netherlands
3 Erasmus University Medical Center Partner Netherlands