BBI at the Society of Critical Care Medicine: Advances in genomics, monitoring to impact critical care market.

BBI at the Society of Critical Care Medicine

Advances in genomics, monitoring to impact critical care market

By GARY PAUL

BBI Contributing Writer

SAN DIEGO, California The 31st annual congress of the Society of Critical Care Medicine (SCCM; Des Plaines, Illinois), held here in late January, provided a forum for the introduction of a number of new products for use in the critical care setting, as well as a window on the future of patient management in intensive care.

A key theme for the meeting, which attracted over 4,500 attendees, was the impact of new developments in genomics in critical care medicine. Although the relevance of genomics for patient management in the intensive care unit (ICU) may not be as obvious as, for example, in the diagnosis and treatment of genetic disease, recent studies indicate that a patients genetic predisposition may play a very important role in determining outcome, including the likelihood of surviving a stay in the ICU.

Another important topic addressed at the congress, and strongly emphasized by the society, is workforce issues in the ICU, including staffing shortages as well as the way in which critical care is structured in the U.S. The need for an improved organizational structure and for better approaches to information management in the ICU is expected to create opportunities not only for intensivists who deliver care to critically ill patients, but also for suppliers of critical care information systems. Although, as shown in Table 6, the number of ICUs is not growing overall, and is declining in some categories, occupancy rates are high and increasing in some cases.

One of the most challenging tasks for intensivists practicing critical care medicine is the management of patients with sepsis. Sepsis is a large and growing problem in medicine. There are about 800,000 cases of sepsis annually in the U.S., with half of those classified as severe, and the condition is the second-leading cause of death in ICUs in the U.S. There is a significant need for improved markers for sepsis, to help detect the condition early before it becomes irreversible, as well as for improved therapies. Recently, a new drug for the treatment of sepsis, Xigris, was introduced by Eli Lilly and Co. (Indianapolis, Indiana), culminating many years of effort by numerous companies, and considerable investment, that had until now failed to produce an effective agent. The progress in sepsis treatment is expected to increase the demand for new technologies for early detection, as well as for technologies for monitoring treatment.

Advances were announced at the SCCM gathering in monitoring technologies for other types of disorders, including techniques for monitoring patients with cardiovascular disease, neurological disease, and trauma.

Another important area of development in critical care medicine is technology for organ and tissue preservation and support. The use of hypothermia to reduce the complications associated with fever is one key focus, as is re-warming of patients in surgery. At least three companies have developed systems for modifying patient temperature for use in cooling patients with fever in the ICU, or for re-warming surgical patients in the operating room. Advances also are continuing in technologies for temporary support of patients with life-threatening kidney and liver disorders.

Genomics, proteomics to revolutionize ICU

Genomics and the related field of proteomics potentially have a great deal to offer intensivists in the ICU for managing critically ill patients. As described by Tim Buchman, MD, PhD, professor of surgery, anesthesiology and medicine at Washington University Medical Center (St. Louis, Missouri), critical illness typically involves changes in expression of multiple genes, resulting in the development of conditions such as septic shock, acute respiratory distress syndrome and multiple …