Therapeutic drug monitoring in the critical care setting remains an area of clinical diagnostics where the time from ordering tests to receiving results is measured in hours rather than minutes. However, administering the correct drug dose is one of the challenging aspects of critical care in many of the patient groups involved, including patients with failure of one or more major organs, paediatrics, geriatrics and the obese.

Sphere Medical is developing a Point of Care drug testing capability to support the more accurate titration of therapeutic drugs to a concentration that is appropriate for an individual patient. The intravenous anaesthetic, propofol, is widely used in critical care, for general anaesthesia in the operating room and for sedation in the intensive care unit. Where the drug is administered under continuous infusion, there are expected to be significant advantages to keeping the drug in a tighter therapeutic window by titrating to concentration rather than relying on the symptoms of a low or high dose to become apparent before the infusion rate is adjusted.

At the present time, the concentration of intravenous anaesthetics in the blood stream cannot be measured in real time. The ability to titrate propofol to plasma concentration is expected to be a key tool in individualising and optimising therapy at the patient level, both in the operating room and the intensive care unit.