What can we learn from COVID

Has anything good come out of the Covid pandemic?  It is difficult to be positive about something that has caused such hardship and led to so many  deaths.  But, as with all disasters, we can learn from it and see what positives we can take.  The public perception of clinical research is surely one area that has gained from all the Covid-related attention.

The UK has led the way in undertaking large scale research, at speed, and with appropriate governance to both protect patients and produce reliable results.  Vaccine testing and the RECOVERY trial are just two examples.  The latter demonstrated very quickly that there is significant benefit to giving a well-established drug, dexamethasone, to certain groups of patients with Covid.  This finding is estimated to have saved hundreds of thousands of lives around the world.

In developing new medical technology, Somnus, too, is undertaking clinical research.  We are at a stage where we need human blood to test our laboratory prototype.  Having received permission from the Heath Research Authority for the  study, Somnus commissioned the RUH in Bath to approach patients and seek their permission to take blood samples during anaesthesia.  Dr Rebecca Oram is the clinical researcher asking patients if they will take part.  Becky is targeting patients having specific operations, specifically procedures which will take quite a while.  This is because we would like several blood samples taken over a period of time.  Each sample Becky collects is separated into its liquid (plasma) and cellular parts in the research lab at the RUH.  The plasma fraction is then deep frozen before being transferred to the labs at the University of the West of England (UWE) where our prototype propofol sensor is set up.

At UWE, the plasma is thawed and a part of each sample is used on our protype to see what concentration of propofol we measure.  Another part of the same sample is put through a gold-standard analyser; a large, highly accurate measuring machine in another part of the lab.  In this way we can compare the performance of our novel sensor with the results coming from standard lab-based measurement.

Why is this important?  Up to now there has been no way for a clinician to measure in real time how much propofol is in a patient’s blood.  We have to rely on mathematical calculations for a sophisticated estimation or send samples to a lab which take hours to produce a result that is of no use during an anaesthetic.  Having a real time blood propofol monitor will change the way we can give anaesthesia and sedation and benefit patients, the NHS and the environment.  Our current research with blood taken from patients during their operation will help us to improve the performance of our prototype monitor.  Obviously, the results are not being used for clinical decision making yet!

It is humbling that people agree to take part and we already have a bank of frozen plasma samples taken from patients having propofol-based anaesthesia.  I do wonder if the well-publicised benefit of clinical research reported on television and other news outlets over the past couple of years has increased the willingness of patients to take part in studies such as ours.  Whatever the reason, we couldn’t achieve our goal of developing bed-side propofol measuring devices without their help.

The National Institute for Health Research provides more information about helping with clinical research at https://www.nihr.ac.uk/patients-carers-and-the-public/