Cambridge Medical Technologies

Development of nano-scale fluid sampling and testing systems for non-invasive access to subcutaneous interstitial fluid and electrochemical detection of blood analytes. Convergence of Evidence: The medical literature strongly supports the value of monitoring lactate, base deficit/pH, and glucose in shock management. Military and civilian studies alike conclude that these parameters are independent predictors of outcome and guideposts for therapy. The consensus can be summarized as follows: Lactate and base deficit are essential shock indicators – they rise early in hemorrhagic shock and sepsis, even when vital signs are maintained. They should be measured as soon as possible in patient evaluation, and their clearance (decrease) is a primary goal of resuscitation. Persistently high lactate or large base deficits warrant aggressive intervention (e.g., surgery for hemorrhage control, escalation of sepsis therapy). Many publications go as far as to call lactate a “resuscitation vital sign.” Glucose is a modifiable risk factor in critical illness – hyperglycemia is common and correlates with worse outcomes, so monitoring it is part of comprehensive care. In emergency settings, an unexplained high glucose can be a “red flag” for severe stress. And during ICU care, avoiding extremes of glucose improves recovery. Therefore, glucose monitoring (and control via insulin if needed) is standard in ICU and recommended in trauma once active bleeding is controlled. Trends and simultaneous interpretation: Perhaps the strongest consensus point is that dynamic assessment (trends) beats static. A single lactate value, for example, is not as informative as seeing how it changes with treatment. The same goes for base deficit. Thus, having continuous monitors would naturally align with this mindset – clinicians already want frequent measurements; technology is now offering a way to get them continuously. Moreover, interpreting these values together is powerful. For instance, if both lactate and base deficit are improving, it’s reassuring confirmation; if one is improving but not the other, it prompts questions (e.g., could there be a metabolic quirk, or an error?). If lactate is high but base deficit is not as bad, the patient has concomitant respiratory alkalosis compensating; if both are bad, it’s pure metabolic acidosis – a dire situation. Meanwhile, glucose adds another layer (e.g., a climbing glucose might hint at an adrenaline surge or impending physiological exhaustion). Military Medical Consensus: Across NATO and US military medicine circles, there is recognition that future combat operations will demand more advanced monitoring to save lives in austere conditions. An internal NATO report from 2019 on combat casualty care noted that many preventable deaths occur from “occult hemorrhage” that wasn’t recognized in time. It recommended development of field-deployable lactate monitors as part of the solution. The Medical Technology Enterprise Consortium (MTEC) RPP MTEC-25-09-AMM in Sept 2025) will create an Advanced Medical Monitor (AMM). The AMM program specifically targets devices that “continuously track vital signs and other relevant data” for expeditionary (field) use. The description highlights the need to detect internal injuries and reduce medics’ cognitive load by providing actionable information. While not explicitly listing lactate/pH/glucose in the snippet we have, the phrase “other relevant data” in context clearly refers to exactly these kinds of biomarkers – those that indicate shock and perfusion status beyond what a pulse can tell. Current field monitors lack the ability to detect occult shock and that adding metabolic monitoring (like lactate, pH) alongside vitals could revolutionize triage. Urgency and Conclusion: With a possible future of high-intensity conflicts or mass casualty events, the urgency to integrate pH, lactate, and glucose monitoring into routine vital sign assessment is high. Civilian mass-casualty response and military combat care would equally benefit. It is telling that as of 2025, both scientific consensus and technology have aligned: we know what to monitor (these parameters), and we are finally getting the tools to monitor them continuously. The remaining task is to accelerate research, development, and field-testing so that these innovations can be deployed. We need to support such efforts and collaborations between military, industry (like CMT) to overcome any remaining hurdles (sensor calibration, ruggedization for field, regulatory approval). In practical terms, adding this capability to monitors means a combat medic in 3–5 years might carry a device that not only measures heart rate and blood pressure, but also tells them “Lactate is 6 mmol/L and rising, pH 7.25 – this casualty is in deep shock; prioritize urgent evac,” or conversely, “Lactate coming down from 4 to 2 mmol/L after fluid – resuscitation is working.” That level of insight at point-of-care could dramatically improve outcomes by guiding interventions more intelligently. It brings ICU-level biochemical surveillance to wherever the patient is – the battlefield, the ambulance, the emergency department.

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