Neonatal care: new way to monitor drug levels could spare babies from painful blood tests
This research was completed on 31 December 2014
Published on 26 October 2012
Around one in nine babies born in the UK spends at least a few days in a neonatal unit.1 With such vulnerable babies, it’s particularly important to monitor the levels of medicines in their bodies, so blood samples are taken. This can be painful for babies, distressing for parents and cannot be performed too frequently. Dr Ryan Donnelly, of Queen’s University Belfast, is developing a new way to monitor drug levels, which he believes could improve things for all concerned.
What is the problem and who does it affect?
Estimates suggest nearly 90,000 babies spend a few days or more in neonatal units each year in the UK. Many depend on life-saving medicines. 1-4
“It is vitally important to ensure the levels of medicines in a baby’s body are right, to protect the baby from side effects of treatment,” explains Dr Donnelly. “However, it’s difficult to predict what sort of dosing regimens our most vulnerable newborns need. They are often both sick and premature, so we can’t make any assumptions about how their bodies will deal with each medicine.”
Blood samples are usually taken to check drug levels by pricking the baby’s heel with a needle and squeezing a little spot of blood onto a special card called a Guthrie card – a procedure called the ‘heel-prick test’.
“Often, blood samples cannot be taken frequently enough to monitor drug levels sufficiently, because newborn babies have a limited blood supply. What’s more, heel prick tests can be painful for babies,” says Dr Donnelly. “They can lead to bruising and scarring. Parents, who are already daunted by having a baby in neonatal care, can find the procedure extremely distressing. It can be very difficult for them to witness their baby going through the test.”
What is the project trying to achieve?
Dr Donnelly is developing a new way to monitor drug levels in a baby’s body, which does not involve taking blood samples. The new technique will involve placing a small patch, which looks a bit like a plaster, onto the skin. The surface of the patch is covered by many hundreds of tiny ‘microneedles’.
In this project, Dr Donnelly is fine tuning the design of the microneedle pads by assessing their performance in laboratory studies.
“If you look at the pad with the naked eye, you can see that it’s slightly rough,” explains Dr Donnelly. “If you run your finger across it, it feels like Velcro. The microneedles puncture the outer layer of the skin without causing pain or bleeding – the sensation is said to feel like a cat’s tongue. The needles then swell, allowing skin fluid to be collected. We believe analysis of this fluid would enable frequent, accurate, pain-free monitoring of the level of medicine in a baby’s body.”
What are the researchers’ credentials?
Dr Donnelly and the team at Queen’s University Belfast are world leaders in microneedle technology. They are already developing similar microneedles to deliver drugs to the body, with safety data showing no reports of infection or skin irritation in human volunteers. Dr Donnelly won the Royal Pharmaceutical Society’s prestigious Science Award in 2011, and the GlaxoSmithKline (GSK) Emerging Scientist Award in 2012, for his work on microneedles.
|Project Leader||Professor Ryan Donnelly BSc PhD PGCHET CChem MRSC MPSNI|
|Location||School of Pharmacy, Medical Biology Centre, Queen’s University Belfast|
|Grant awarded||26 July 2012|
|Provisional start date||1 January 2013|
|Provisional end date||31 December 2014|
|Acknowledgements||This project is funded by a generous donation from The Henry Smith Charity.|
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- Office for National Statistics. Births and Deaths in England and Wales (provisional) 2011. http://www.ons.gov.uk/ons/rel/vsob1/death-reg-sum-tables/2011--provisional-/sb-births-and-deaths-first-release--2011.html Website accessed 20 September 2012.
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- General Register Office for Scotland. 2011 Births, Deaths and Other Vital Events – Preliminary Annual Figures. http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/bmd-preliminary/2011.html Website accessed 20 September 2012.