Developing a user-friendly rapid algorithm for quantitative clinical cerebral microdialysis monitoring by mid-infrared spectroscopy for traumatic brain injury patients.

Innovation and health problem: Traumatic brain injury (TBI) has long been recognised as a "silent epidemic" [1] underscoring its widespread impact and there are still unmet needs and urgent demands for enhanced monitoring and intervention strategies [2]. Our initiative is specifically designed to meet this critical need by advancing an existing online continuous microdialysis monitoring system. This online system outperforms the traditional metabolite quantification method, which relies on hourly updates and is both reagent-dependent and labour-intensive. By providing near real-time, labour-saving monitoring solutions, our technology represents a major leap forward in the effective management of TBI, aligning with the global call for improved patient care and outcomes. Stage of development and evidence generated to date: The current system has been tested in a clinical Neuro Critical Care Unit setting and is proven to provide near real-time monitoring of patient metabolites effectively. Our previously published work substantiates the foundational technology and its initial clinical applications [3,4,5]. We have a proof-of-concept Partial Least Squares (PLSR) algorithm for converting technical absorbance measures into actual concentrations [3]. However it is currently an offline method that needs streamlining to be implemented in real-time, and we will also evaluate other algorithm approaches which may be quicker and more efficient (see 2. Research Question and Project Plan, below). Our work has been presented at numerous international conferences, including the Federation of European Neuroscience Societies (FENS) Conference 2022 in Paris, the International Neurotrauma Symposium (INTS) 2022 in Berlin, the ICP Symposium 2023 in Cape Town, the UK Critical Care Research Group Conference (UKCRG) 2024 in Southampton, and the International Neurotrauma Society Conference (INTS) 2024 and its associated Cerebral Microdialysis Satellite Symposium 2024, both in Cambridge, UK. These presentations have not only facilitated widespread scholarly exchange but also attracted significant interest from the international scientific community – enhancing our system's visibility and credibility. Additionally, local outreach efforts have also been done, such as to schools (e.g. the Joyce Frankland Academy, Essex), and patients and the public (e.g. Addenbrooke s Hospital PPI group), demonstrating our commitment to educational engagement and community involvement. Input from public and patient members: Input from clinical staff and patient advocacy groups has been vital in identifying areas for improvement within our system. Specifically, the need for a more intuitive data presentation format has been highlighted. Mr. Jeremy Dearling, a key member of our group serving in a patient and public involvement (PPI) role, has provided invaluable insights that highlight the need for translating absorbance data into more clinically familiar concentration metrics. This feedback is pivotal in driving the current proposal to refine the algorithm, ensuring it meets the practical needs of both clinicians and patients in real-world settings.