Need for Inpatient Glycemic Control

The intensive care units have a very high prevalence of hyperglycemia (> 40%). Additionally, hypoglycemia and glycemic variability are well recognized risk factors. It was not until 2001 that a “landmark” study by Berghe et.al. established the need for tight glycemic control [i.e., normalizing glucose through intensive insulin therapy] in ICUs. Significant reduction in mortality, morbidity (due to sepsis, renal failure, blood transfusion), and length of stay (LoS) savings were observed. Financial savings were estimated at $3,345/patient due to reduced LoS and avoided interventions. However despite protocols calling for tight glycemic control, there was poor compliance due to the existing labor-intensive and sub-par accuracy measurement methods which were typically based on capillary fingerstick sampling and meter/strips. The US Medicare system instituted “no-pay” guidelines for complications that arise from poor glucose control. 

Challenges with Sepsis Management

Sepsis (defined as a dysregulated host response to infection that causes life-threatening organ dysfunction) is typically caused by blood-borne infections, which may be bacterial, viral or otherwise. Specifically, upon the earliest suspicion of Sepsis, the blood lactate levels should be assessed as part of the Surviving Sepsis Protocol, which helps to rule out or identify the root cause of a lactate elevation. If lactate is elevated (> 2 mmol/L), it can be due to elevated glucose values (known by glucose monitoring), internal bleeding (known by Hemoglobin monitoring), need for resuscitating fluids (known by Central Venous Oxygen Saturation), organ failure (known by cardiac monitoring), and blood infection. The knowledge of the "big four" analytes enables the "race" to administer triple anti-biotic therapy, which is today delayed considerably. 

Shortcomings of Existing Solutions

Blood glucose monitoring is currently done using labor intensive fingerstick based meters/strips offered by companies like Roche Diagnostics, Nova Biomedical, and Abbott or by interstitial fluid based continuous glucose monitoring systems from companies like Medtronic and Dexcom - which are known of have sub-optimal accuracy in critical care. Multi-analyte measurements are typically done using point-of-care instruments like the Abbott i-Stat and the Siemens epoc which employ single-use cards/cartridges. Alternatively, they are performed using blood gas analyzers with a multi-use cartridge from companies like Radiometer (Danaher), Instrumentation Laboratories (Werfen). Not only are blood gas analyzers labor intensive, they also are associated with long turn around times, have high cost, expose the care giver to infectious blood and above all result in substantial blood loss to the patient. Central venous oxygen saturation measurements utilize dedicated central venous catheter based fiber-optic systems from companies like Edwards Lifesciences and ICU Medical, but their use remains restricted. 

The CMX Solution: AutoPlexer

Other Blood Analytes: CMX plans to add other time sensitive tests to the AutoSampler platform. Whole blood sensors to monitor blood gases, electrolytes and multiple other biomarkers will be integrated to the plataform. Combining leading edge innovations in micro-fluidics, electro-chemistry, and machine intelligence, CMX has developed patentable inventions covering technologies, designs, and other relevant operational aspects.

Critical Care Stats in the US and a visual illustration of the AutoPlexer is provided below. 

FOUNDERS

Kislaya Kunjan, PhD, MBA is the Co-founder and CEO of Cascade Metrix. He is the lead inventor of the product technology and is managing the company's product and business development aspects in collaboration with its partners and strategic investors alike. He holds an M.S. in Mechanical Engineering from Purdue (West Lafayette, IN) and an MBA from Cornell University (Ithaca, NY). While at Purdue, he designed and developed a novel infrared glucose sensing system under the mentorship of Prof. Jay Gore. His prior professional experience spans sales engineering with Saint-Gobain, medical device development with Vista  Biosciences, product manager at Johnson & Johnson/LifeScan and the Chief Informatics Officer at the Indiana PCA. He completed his PhD in Health Informatics from the Indiana University School of Informatics and Computing (Indianapolis, IN). 

Frank Lloyd, Jr, M.D. MBA is a Co-founder and Chief Engagement Officer of Cascade Metrix. He has led clinical research and development through his association with industry and academia for more than 20 years. He has also held appointments as a Clinical Associate Professor in Surgery at the Indiana University School of Medicine, President of the Center of Surgical Sciences and Trauma, and Medical Director of Methodist Research Institute. Dr. Lloyd graduated from IU School of Medicine, followed by a residency in general surgery from Howard University (Washington DC), and a fellowship in surgical oncology from Roswell Park Memorial Hospital (Buffalo, NY). He also completed the physician MBA program from IU's Kelley School of Business. He has been elected twice as the Coroner of Marion County, Indianapolis.

David T. Giddings is a Co-Founder and serves as Chief Development Officer of Cascade Metrix. His business career has been focused on healthcare, information technology, and life sciences businesses with both established and emerging publicly & privately held companies. He was with Eastman Kodak in General Management positions in Kodak's commercial Imaging and Information Systems and Healthcare Groups. Mr. Giddings joined Boehringer Mannheim Corporation in 1991 as VP and General Manager of their diagnostics Division and subsequently became President and COO of the company. He was appointed Chairman, President, and CEO of Diametrics Medical in 1995, a NASDAQ traded company, where he served for 6 years. Mr. Giddings served as  Digilab Inc’s President & CEO until July, 2009, and remains an active shareholder in the company.

ADVISORY BOARD

Peter Rule is a key strategic advisor for Cascade Metrix. He has had a 30 year career leading medical device and diagnostic companies from early start up to beyond an IPO.  In diabetes, Peter led MiniMed as its President and Chief Operating Office and member of the Board of directors (now Medtronic Diabetes Care), establishing the insulin pump market in the US and starting the CGM franchise as a separate team.  He was also a co-founder and Chairman of the Board of Therasense (now Abbott Diabetes Care), establishing the direction for the first ultra-low blood sampling meter (“Freestyle”) and the Navigator CGM. Other successful companies Peter has led include PercuSurge, the world’s first embolic protection company in interventional cardiology, also purchased by Medtronic, and Ekos Corporation, a drug device delivery company for the treatment of Pulmonary Embolism, DVT, and PAO, purchased by BTG.  Peter has been involved in the design of over 20 clinical trials, and was on the advisory board of the Diabetes Control and Complications Trial (DCCT).  Peter is a named inventor on over 50 US patents. Recently, Peter led the creation of the first ICU CGM at OptiScan Biomedical, leaving after gaining FDA approval. Peter currently consults to early stage and established device and diagnostic companies, through his consulting firm PRI. Clients include breakthrough diabetes companies. Peter has an undergraduate degree from the University of Southern California and an MBA from Harvard University. 

Raj Kapoor, MD, MBA, FCCP  is a medical advisor for Cascade Metrix. Raj is an experienced physician leader, medical director, innovator, and educator at Indiana University Health and IU’s School of Medicine. Raj currently serves as the Cardiovascular Critical Care Medical Director at IU Health, supervising the Respiratory Care Medical Department for the Academic Health Center in Indianapolis. He is also a Clinical Professor in the medical school’s Department of Medicine, Division of Pulmonary and Critical Care Medicine. As a physician leader, Raj has led quality initiatives, protocol development, and the LEAN approach to continuous improvement to improve access and patient experience, physician burnout, and employee engagement. Raj earned Bachelor of Medicine and Bachelor of Surgery Medicine degrees from Maulana Azad Medical College, a top medical education college in India. He also received an MBA in the Business of Medicine from IU’s Kelley School of Business. He is board certified in internal medicine, critical care medicine, and pulmonary medicine.  

Peter T. Kissinger, Ph.D., is a scientific advisor for Cascade Metrix. He was the founder of Bioanalytical Systems, Inc., (NASDAQ BASI) - a life science contract research firm, which he led from 1974-2007, and is Professor of Bioanalytical Chemistry at Purdue University. Dr. Kissinger has published more than 230 scientific papers and is a Fellow of the American Association of Pharmaceutical Scientists and the American Association for the Advancement of Science. In 2005, he became the Chairman of Prosolia, which markets mass spectrometry innovations for life science, industrial and homeland security applications. In 2007, he and Candice Kissinger founded Phlebotics, Inc., a medical device company focused on diagnostic information for intensive care medicine.

Cascade Metrix (CMX) is a medical technology company working within a new paradigm in critical care. The company will introduce an Automated Multiplex Analyzer ["AutoPlexer"] that will revolutionize the bedside testing of hospitalized patients whose care and recovery is dependent on repetitive, around-the-clock measurements of critical blood parameters. This innovative and proprietary ex-vivo blood analysis system is first being applied to the automated multiplex measurement of glucose, lactate, hemoglobin and oxygen saturation in critically ill patients and will over time expand to include multiple other biomarkers of interest.

Latest Update: CMX has been awarded a SBIR Phase II grant [2R44GM146498-02; A Multiplex analyzer for Sepsis and Beyond; PI Kislaya Kunjan, PhD; 2025-28) from National Institutes of Health; RePORTER.NIH.gov Portal]. This was following the successful completion of the SBIR Phase I grant deliverables. In addition to this, Elevate Ventures had provided additional non-dilutive matching funds.

CMX has completed the prototypical development and preclinial validation of the AutoPlexer solution to support early diagnosis and treatment of critical care conditions like sepsis, and trauma. Efforts are currently underway for inpatient trials ahead of regulatory filings. 

CMX is seeking investment as well as partnership opportunities with firms in the medical technology, health systems and related areas. Please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for further details.