?Studies in the pediatric intensive care unit (PICU) have shown that hypoglycemia, hyperglycemia as well as swings in blood glucose levels are strongly associated with higher morbidity and mortality. However, tight glucose control has not been proven as effective. In fact, hypoglycemia was found to be a real danger. Thus, there is a need for more careful study, collection of more data using standardized methods over a larger cohort in the PICU. However, multiple painful blood withdrawals or an indwelling needle cause additional stress to both the young patients in the PICU, their parents and caregivers. Here we propose to develop a painless, minimally invasive glucose sensing system designed especially for patients in the PICU. Microneedles (MNs, between 250 to 750µm in length), will be used to create microchannels in the outer layer of dead cells (corneocytes) on the skin. A small biosensor patch containing a highly sensitive (Kd ~ µM) optical glucose biosensor will be placed over these microchannels to allow glucose to diffuse. The rate of diffusion of glucose will then be measured using a handheld minifluorometer. The device will be tested and optimized in vitro on model skin and on selected healthy subjects and patients in the PICU.
Public Health Relevance Statement: Public Health Relevance: The current method to monitor blood glucose levels in the pediatric intensive care unit requires painful withdrawal of blood every hour over many hours, which adds to the stress of being in the hospital for these young patients. Instead of bleeding, we are proposing to use tiny needles to painlessly create small holes on the outer layer of dead cells on the skin. A very sensitive glucose biosensor will then detect the small amount of glucose that diffuses through these tiny holes. For this proposal, we organized a group of scientists, physicians and engineers to develop this painless glucose monitoring device that can be used in the pediatric intensive care unit.
Project Terms: Admission activity; Adult; Agreement; Area; Baltimore; Biosensor; Blood; Blood Glucose; blood glucose regulation; Calibration; Caregivers; Cells; Childhood; Clinical; cohort; Collection; County; Data; design; Devices; Diffuse; Diffusion; Drug Delivery Systems; Engineering; Equation; Family suidae; Fingers; Glucose; glucose monitor; Glucose tolerance test; Hemorrhage; Hospitals; Hour; Hyperglycemia; Hypoglycemia; In Vitro; in vivo; irritation; Length; Maryland; Measurement; Measures; medical schools; Methods; minimally invasive; Modeling; Monitor; monitoring device; Morbidity - disease rate; mortality; multidisciplinary; Needles; Optics; Pain; Painless; Parents; Patients; Pediatric Intensive Care Units; pediatric patients; Performance; Pharmacy Schools; Physicians; Principal Investigator; programs; prototype; public health relevance; research study; routine care; Sampling; Scientist; sensor; Skin; Statistical Data Interpretation; Stratum corneum; Stress; System; Testing; Thick; Time; Universities; Water; Withdrawal
