Blood lactate level is closely associated with the prognosis of patients with sepsis and septic shock. Clinical guidelines explicitly recommend blood lactate monitoring in septic patients and lactate-guided fluid resuscitation when lactate levels are elevated. Dynamic monitoring of serum lactate changes and calculation of lactate clearance can more accurately reflect the dynamic changes in tissue oxygen supply and consumption, and can be used to evaluate tissue perfusion and oxygen metabolism. However, most existing wearable sweat sensors have a detection range of only 0-20 mmol/L, which is suitable only for monitoring during exercise under normal physiological conditions and cannot meet the clinical monitoring needs of patients with hyperlactatemia. In addition, current wearable sweat lactate sensors suffer from poor reproducibility and are easily affected by environmental factors and complex sweat composition, which represent major obstacles to clinical translation. Therefore, this project aims to develop a wearable sweat sensor for high-concentration lactate monitoring and to conduct preliminary clinical validation in critically ill patients, by simultaneously measuring blood and sweat lactate concentrations and establishing their correlation, with the goal of achieving non-invasive and convenient disease monitoring through sweat biomarker detection.
Admitted to the surgical intensive care unit (ICU)
Blood lactate concentration > 1.5 mmol/L
Age ≥ 16 years
Willing to voluntarily donate samples and provide signed informed consent
Pregnant women
Pre-existing hematologic disease prior to infection
Long-term use of immunosuppressive agents or presence of immunodeficiency
Skin too dry to allow adequate sweat collection
Critically ill patients admitted to the surgical intensive care unit (ICU) of the First Affiliated Hospital of Xi'an Jiaotong University with blood lactate concentration greater than 1.5 mmol/L, indicating hyperlactatemia associated with conditions such as sepsis or septic shock. Eligible patients will be assigned to either a sweat collection group or a wearable device monitoring group for concurrent measurement of blood and sweat lactate concentrations.
Cohort
Prospective
High-Concentration Sweat Lactate Wearable Monitoring Device
DeviceA flexible wireless wearable device integrating a lactate detection electrode, pH detection electrode, temperature detection electrode, sweat-stimulating electrode, microfluidic sweat collection module, sweat-inducing hydrogel patch, and flexible integrated circuit with an intelligent display system. The device induces localized non-exercise sweating via electrical stimulation and enables real-time detection of sweat lactate concentration up to 100 mmol/L.
Commercial Sweat Collection Device (HELA)
DeviceA commercially available sweat collection device (HELA) used to collect sweat samples from critically ill patients at the time of routine blood draws for clinical lactate testing. Collected sweat samples are subsequently analyzed for lactate concentration using ELISA in the laboratory.
Sweat Lactate Concentration
Sweat lactate concentration will be measured in critically ill patients with blood lactate concentration \>1.5 mmol/L, either via laboratory (ELISA) analysis of sweat samples collected using a commercial sweat collection device, or via real-time detection using the investigator-designed wearable sweat sensor. The correlation between sweat and blood lactate concentrations will be analyzed using Pearson correlation to establish the sweat lactate concentration range corresponding to hyperlactatemia.
Correlation Between Sweat Lactate Concentration Measured by the Wearable Device and Blood Lactate Concentration Measured by Standard Clinical Testing
Sweat lactate concentration (mmol/L) obtained from the wearable device will be compared with corresponding blood lactate concentration (mmol/L) obtained through standard clinical laboratory testing, using correlation analysis (e.g., Pearson or Spearman correlation coefficient) and Bland-Altman agreement analysis.
Number of Participants With Device-Related Skin Adverse Events
Number of participants experiencing skin irritation, discomfort, or other adverse events at the sensor application site, assessed through clinical observation during device use.
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