Personalised Simulation Technologies for Optimising Treatment in the Intensive Care Unit: Realising Industrial and Medical Applications

In the UK, approximately 142,000 people are admitted to Intensive Care Units (ICU) each year. A large proportion of these patients have life-threatening pulmonary illness and require mechanical ventilation; the mortality rate in this group is around 35%, and even survival may bring ongoing suffering lasting years after discharge. Critical pulmonary disease thus has enormous financial impact and represents a significant burden of suffering for the general population. Despite years of research, there has been a lack of progress in our understanding of critical illness and in our ability to personalise treatment. Traditional clinical research approaches (using randomised clinical trials) have been costly and often inconclusive, and have provided disappointing improvements in critical care (diagnosis, survival, cost-effectiveness). The development of more effective personalised treatments for this patient population would therefore have significant national and global impact. In this project, we will develop novel methods for personalising and optimising the therapy delivered in the ICU. We will work closely with our business and clinical partners to transfer our high-fidelity modelling technologies from the research lab to the ICU, in order that real-time, personalised, patient simulation can be achieved with the aim of guiding the treatment of critical illness. This approach offers potentially "low-cost" improvements in patient-care, since it is based on smarter strategies and technologies that exploit and optimise multiple interventions, without requiring expensive new pharmaceuticals or devices. Using large-scale integration of incoming data streams from routine patient monitoring, our technology will allow us to establish a matched simulation of an individual patient's physiology. The resulting personalised bedside simulation will allow clinicians to test planned interventions and to estimate vital parameters in the patient that would otherwise be inaccessible. In addition to acting passively, the technology will proactively advise on optimised treatment strategies that are expected to improve patient outcome. The technology will scan the patient's treatment and physiological data continually, seeking potential improvements in management, and testing proposed treatment strategies by applying them to the personalised simulation and assessing outcome.Personalised optimisation of critical care treatment offers the opportunity to improve patient outcomes and reduce days spent receiving mechanical ventilation in the intensive care unit, and has the potential for enormous impact in terms of reducing patient suffering and healthcare expenditure. We will make this potential a reality by working closely with our business partner Medtronic (the world's largest standalone medical technology development company, and a leading ventilator manufacturer) and with our clinical partner Prof. Luigi Camporata, a consultant in intensive care medicine at Guy's and St Thomas' NHS Foundation Trust (one of the UK's leading centres for research on the treatment of critical illness).