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Ciatti JL, Vázquez-Guardado A, Brings VE, Park J, Ruyle B, Ober RA, McLuckie AJ, Talcott MR, Carter EA, Burrell AR, Sponenburg RA, Trueb J, Gupta P, Kim J, Avila R, Seong M, Slivicki RA, Kaplan MA, Villalpando-Hernandez B, Massaly N, Montana MC, Pet M, Huang Y, Morón JA, Gereau RW, Rogers JA. An autonomous implantable device for the prevention of death from opioid overdose. SCIENCE ADVANCES 2024; 10:eadr3567. [PMID: 39441938 PMCID: PMC11498215 DOI: 10.1126/sciadv.adr3567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 09/17/2024] [Indexed: 10/25/2024]
Abstract
Opioid overdose accounts for nearly 75,000 deaths per year in the United States, now a leading cause of mortality among young people aged 18 to 45 years. At overdose levels, opioid-induced respiratory depression becomes fatal without the administration of naloxone within minutes. Currently, overdose survival relies on bystander intervention, requiring a nearby person to find the overdosed individual and have immediate access to naloxone to administer. To circumvent the bystander requirement, we developed the Naloximeter: a class of life-saving implantable devices that autonomously detect and treat overdose while simultaneously contacting first responders. We present three Naloximeter platforms, for fundamental research and clinical translation, all equipped with optical sensors, drug delivery mechanisms, and a supporting ecosystem of technology to counteract opioid-induced respiratory depression. In small and large animal studies, the Naloximeter rescues from otherwise fatal opioid overdose within minutes. This work introduces life-changing, clinically translatable technologies that can broadly benefit a susceptible population recovering from opioid use disorder.
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Affiliation(s)
- Joanna L. Ciatti
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
| | - Abraham Vázquez-Guardado
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
- Department of Electrical and Computer Engineering, North Carolina State University, Raleigh, NC 27606, USA
| | - Victoria E. Brings
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jihun Park
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
| | - Brian Ruyle
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University, St. Louis, MO 63110, USA
| | - Rebecca A. Ober
- Center for Comparative Medicine, Northwestern University, Evanston, IL 60208, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Alicia J. McLuckie
- Center for Comparative Medicine, Northwestern University, Evanston, IL 60208, USA
| | - Michael R. Talcott
- Division of Cardiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Emily A. Carter
- Center for Comparative Medicine, Northwestern University, Evanston, IL 60208, USA
| | - Amy R. Burrell
- Center for Comparative Medicine, Northwestern University, Evanston, IL 60208, USA
| | - Rebecca A. Sponenburg
- Chemistry of Life Processes Institute (Quantitative Bio-element Imaging Center), Northwestern University, Evanston, IL 60208, USA
| | - Jacob Trueb
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
| | - Prashant Gupta
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Joohee Kim
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
| | - Raudel Avila
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Minho Seong
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
| | - Richard A. Slivicki
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Melanie A. Kaplan
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Bryan Villalpando-Hernandez
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
| | - Nicolas Massaly
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Michael C. Montana
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Mitchell Pet
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yonggang Huang
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
- Department of Mechanical Engineering, Northwestern University, Evanston, IL 60208, USA
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Jose A. Morón
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University, St. Louis, MO 63110, USA
| | - Robert W. Gereau
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA
- Washington University Pain Center, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Neuroscience, Washington University, St. Louis, MO 63110, USA
- Department of Biomedical Engineering, Washington University, St. Louis, MO 63110, USA
| | - John A. Rogers
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL 60208, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL 60208, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Ciatti JL, Vazquez-Guardado A, Brings VE, Park J, Ruyle B, Ober RA, McLuckie AJ, Talcott MR, Carter EA, Burrell AR, Sponenburg RA, Trueb J, Gupta P, Kim J, Avila R, Seong M, Slivicki RA, Kaplan MA, Villalpando-Hernandez B, Massaly N, Montana MC, Pet M, Huang Y, Morón JA, Gereau RW, Rogers JA. An Autonomous Implantable Device for the Prevention of Death from Opioid Overdose. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.27.600919. [PMID: 39005313 PMCID: PMC11244915 DOI: 10.1101/2024.06.27.600919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Opioid overdose accounts for nearly 75,000 deaths per year in the United States, representing a leading cause of mortality amongst the prime working age population (25-54 years). At overdose levels, opioid-induced respiratory depression becomes fatal without timely administration of the rescue drug naloxone. Currently, overdose survival relies entirely on bystander intervention, requiring a nearby person to discover and identify the overdosed individual, and have immediate access to naloxone to administer. Government efforts have focused on providing naloxone in abundance but do not address the equally critical component for overdose rescue: a willing and informed bystander. To address this unmet need, we developed the Naloximeter: a class of life-saving implantable devices that autonomously detect and treat overdose, with the ability to simultaneously contact first-responders. We present three Naloximeter platforms, for both fundamental research and clinical translation, all equipped with optical sensors, drug delivery mechanisms, and a supporting ecosystem of technology to counteract opioid-induced respiratory depression. In small and large animal studies, the Naloximeter rescues from otherwise fatal opioid overdose within minutes. This work introduces life-changing, clinically translatable technologies that broadly benefit a susceptible population recovering from opioid use disorder.
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Milford K, von Delft D, Majola N, Cox S. Long-term vascular access in differently resourced settings: a review of indications, devices, techniques, and complications. Pediatr Surg Int 2020; 36:551-562. [PMID: 32200406 DOI: 10.1007/s00383-020-04640-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 11/26/2022]
Abstract
Central venous access is frequently essential for the management of many acute and chronic conditions in children. Millions of central venous access devices (CVADs) are placed each year. In this review article, we discuss the indications for long-term vascular access, the types of devices available, the state of the art of central venous cannulation and device placement, and the complications of long-term central venous access. We pay a special attention to the challenges of, and options for long-term central venous access, also those in developing countries, with limited financial, human, and material resources.
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Affiliation(s)
- Karen Milford
- The Division of Urology, The Hospital for Sick Children, The University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Dirk von Delft
- Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Nkululeko Majola
- Department of Paediatric Surgery, Frere Hospital, Walter Sisulu University, East London, South Africa
| | - Sharon Cox
- Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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