
The ACMECat project is launched to improve the diagnosis of tissue hypoxia in critically ill patients
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- Oriol Capell
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- Detecting and treating tissue hypoxia of cardiovascular origin in time is essential to avoid a deterioration of organic functions and reduce the morbidity and mortality of critically ill patients
- The study combines the analysis of blood markers, which reflect the metabolic state of the tissues, with the direct monitoring of cardiac function using invasive catheters
The ACMECat multicentre project, led and coordinated by the research group on hemodynamics, microcirculation and tissue oxygenation in the critically ill patient (MiTOCrit) of the I3PT, has started this month the patient inclusion phase with the aim of deepening the detection of tissue hypoxia in critically ill patients.
This condition occurs when the body tissues do not receive a sufficient amount of oxygen due to a problem in the cardiovascular system, such as heart failure or a decrease in blood flow. This can happen in critically ill patients, especially those suffering from severe infectious processes or septic shock.
"It is fundamental detect and treat it in time because the lack of oxygen in the tissues can lead to a deterioration of the organic functions, increasing the risk of morbidity and mortality in the patient”, points out Jaume Mesquida, head of the group and principal researcher of the study. Early detection allows therapeutic interventions to be carried out to improve tissue oxygenation and avoid irreversible damage, thus improving the patient's survival and recovery.
The project is supported by the Catalan Society of Intensive and Critical Medicine (SOCMIC) and the active participation of 12 intensive care units (ICU) from all over the Catalan territory, which will include critical patients who meet specific criteria for cardiac and metabolic monitoring, including those of the Vall d'Hebron Hospital, the Germans Trias i Pujol Hospital, the Hospital del Mar, the Hospital de la Santa Creu i Sant Pau, Hospital Quirón-Teknon, Hospital de Mataró, Hospital de Granollers, Hospital Joan XXIII, Hospital Mútua de Terrassa and Hospital de Manresa.
The patient inclusion phase will have an approximate duration of two years and will be done through a centralized digital platform that will facilitate the monitoring of the rate of recruitment by the ICUs involved, and will allow the necessary actions to be adjusted to achieve the objectives within the established deadlines.
A project born in Parc Taulí
ACMECat has its origins in a unicentric preliminary study carried out at Parc Taulí. The results, despite being obtained with a small sample of 50 patients over 3-4 years, were very promising, and motivated their expansion on a multicenter scale.
The study combines the analysis of markers in blood, which reflect the metabolic state of the tissues, with the direct monitoring of cardiac function using invasive catheters. This advanced and rare approach in routine clinical practice allows obtaining very precise data on the patients' condition.
"Today, we have different blood markers that inform us about the overall metabolic state of the body. Each of these markers has shown its value in the detection and management of tissue hypoxia, but they all have their own limitations", emphasizes Ferran Oller, researcher of the MiTOCrit group and co-principal investigator of the project together with Mesquida.

The research group of Hemodynamics, microcirculation and tissue oxygenation in the critically ill patient (MiTOCrit)
In this way, the group has combined classic and new markers for improve the accuracy in the detection of tissue hypoxia and identify patterns that allow this condition to be distinguished in more detail, as well as to detect states of dysoxia, where the tissues show an inability to use the oxygen that reaches them. This situation is of particular interest because, in cases of dysoxia, hemodynamic interventions to increase tissue oxygen delivery would not only be unhelpful in improving tissue metabolism, but could lead to harmful effects for patients.
The ACMECat project, with its multicentric nature, and the inclusion of a large number of patients, aims deepen the ability to discriminate between these pathological metabolic states, thus helping to improve the therapeutic approach of critically ill patients.
ACMECat represents an opportunity to advance the treatment of critically ill patients and strengthen collaboration between health centers. If the results continue in the right direction, this research could transform the therapeutic approach to septic shock, significantly improving the prognosis and the quality of care for patients in the ICU", concludes Mesquida.
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