Together, researchers at the University of Pittsburgh and the University of Pittsburgh Medical Center are working to quickly identify and treat shock, a problem that affects an estimated 1 million emergency room patients every year. Circulatory shock, which is caused by a variety of problems such as heart attacks, happens when not enough blood reaches organs and other tissues. Time is therefore critical: The focus of efforts is to try to find better ways to diagnose shock earlier and reverse it.
As reported in the Pittsburgh Business Times, shock-related studies at Pitt include a $9.4 million study that is enrolling 1,950 people suffering from septic shock, which is caused by a massive internal infection. The National Institutes of Health-funded study will determine whether the number of shock deaths can be reduced by following specific steps. Also, a $600,000 study completed last year and funded by the Air Force showed a correlation between a simple blood test and the earliest signs of shock.
To help speed up identification of circulatory shock, McGowan Institute for Regenerative Medicine
faculty member Michael Pinsky, MD (pictured), Professor of Critical Care Medicine, Anesthesiology and Bioengineering at the University of Pittsburgh School of Medicine, is working on a unique diagnostic medical device currently in clinical trials. In early shock, blood vessels constrict, which shunts blood away from fingers, toes, and other extremities, and into the body core and vital organs such as kidneys and brain. Dr. Pinsky’s device will quickly measure the vascular tension that makes this shift of blood possible, which will eventually help guide treatment decisions.
The device—named CVInsight—could provide the earliest warning yet for circulatory shock, a problem that can be fatal in up to 20 percent of cases, Dr. Pinsky said. CVInsight is a non-invasive medical device that overcomes the limitations of the current protocol of using static vital signs as a basis for assessing cardiovascular sufficiency. By performing a rapid and safe bedside test, the CVInsight device provides a functional measure of a patient’s cardiovascular stability, or lack thereof. The assessment of cardiovascular stability is performed using a stress test created from a passive leg raise; a proven way to create a safe cardiovascular “stress” measurement.
Recent advances in the understanding of the dynamic nature of circulatory control have introduced novel hemodynamic monitoring approaches that are continuous, noninvasive, and metabolic in their orientation. When these monitoring strategies are used as physiology-based feedback to guide caregiver-directed protocolized therapy, they can lead to a new and robust approach to the resuscitation of trauma patients. CVInsight meets the need for a device that can be used by a lesser competent care provider, such as emergency response personnel, so that critically ill patients can receive effective shock treatment quickly.
Symptoms of circulatory shock can be as vague as feelings of anxiety. Standard diagnostic tools, such as heart rate and blood pressure, don’t always reflect trouble that’s brewing inside. The result can be delayed diagnosis, which complicates treatment.
Illustration: McGowan Institute for Regenerative Medicine.
Pittsburgh Business Times (02/26/10)
Free Patents Online: Device and system that identifies cardiovascular insufficiency (03/16/10)
The Pittsburgh Life Sciences Greenhouse (07/11/07)
Bio: Dr. Michael Pinsky