Transforming cardiac recovery with real-time lactate monitoring
Imagine a clinic where vital signs are not just recorded intermittently but monitored continuously. A skin-worn sensor feeds data directly to the clinical team, and delays between observation and action are significantly reduced.
This is not science fiction, it is a possible future. The Continuum L study, led by Professor Anthony Mathur at Queen Mary University of London and delivered by the Barts Cardiovascular Clinical Trials Unit (CVCTU), is actively exploring this.
At the centre of this single-centre feasibility study is a small, skin-adhered device that continuously measures lactate, a key marker of tissue oxygenation. In cardiac surgery, where metabolic stress and oxygen delivery are monitored closely, real-time data could support earlier intervention and more personalised care.
Currently, lactate is measured through intermittent blood testing. This provides only isolated data points and is often delayed by the time it takes to collect, transport and analyse samples (not to mention the discomfort to patients). The sensor has developed by Landmark Medicines Ltd (previously Nemaura Pharma Ltd) and captures lactate in interstitial fluid beneath the skin, offering continuous readings without the need for repeated blood draws.
Continuum L is not only testing the device’s accuracy, it is contributing to a wider ambition: incorporating continuous physiological and biochemical data into predictive models. Models such as those developed by the Digital Twin Project at Queen Mary. This initiative aims to build clinical tools that simulate real-time responses to support earlier clinical decisions.
To do this effectively, strong validation is essential. The study will compare the sensor’s lactate readings with standard venous and arterial measurements and assess their relationship with troponin, a key indicator of heart damage. While troponin remains a critical diagnostic tool, it typically rises several hours after the onset of injury and still requires repeated blood tests. If continuous lactate monitoring can help identify risk earlier, it could support faster, more informed treatment decisions.
The study is recruiting up to 76 participants undergoing elective coronary artery bypass and valve surgery at St Bart’s. Researchers will also evaluate the device’s safety, usability and acceptability in a surgical care setting.
Nearly three million A&E visits in early 2023 were related to chest pain, with more than 1.3 million enzyme tests carried out during that time. With this level of demand, there is clear clinical value in wearable tools that reduce reliance on repeated sampling and could speed up diagnostic decision making.
CVCTU is proud to support research that not only improves what is possible now but helps build the future of personalised, data-driven care.
To learn more about Continuum L, or to speak to the study team, contact: whri-brc-cvctu@qmul.ac.uk