Electrochemical hematocrit determination in a direct current microfluidic device

Automatic characterization of capillary flow profile of liquid samples on μTADs based on capacitance measurement

Capillary flow profile of liquid samples in porous media is closely related to the important properties of liquid samples, including the viscosity and the surface energy. Therefore, capillary flow profile can be used as an index to differentiate liquid samples with different properties. Fast and automatic characterization of capillary flow profile of liquid samples is necessary. In this work, we develop a portable and economical capacitance acquisition system (CASY) to easily obtain the capillary flow profile of liquid samples on microfluidic thread-based analytical devices (μTADs) by measuring the capacitance during the capillary flow. At first, we validate the accuracy of this method by comparing with the traditional method by video analysis in obtaining the capillary flow profiles in μTADs of cotton threads or glass fiber threads. Then we use it to differentiate liquid samples with different viscosity (mixture of water and glycerol). In addition, capillary flow profile on μTADs with chemical valves (chitosan or sucrose) can also be obtained on this device. Lastly, we show the potential of this device in measurement of hematocrit (HCT) of whole blood samples. This device can be used to catalog liquid biological samples with different properties in point-of-care diagnostics in the near future.

Simultaneous quantitative detection of hematocrit and hemoglobin from whole blood using a multiplexed paper sensor with a smartphone interface

We report a highly accurate single-step label-free testing technology for simultaneous and independent hematocrit (Hct) and hemoglobin (Hb) level detection from a drop of whole blood by employing a disposable paper strip sensor interfaced with a portable impedimetric device. The paper strip is fabricated by in situ automated printing of a customized electrode template on the non-glossy side of a commercially available photo paper substrate followed by graphite deposition. The integrated platform device technology additionally includes a compact detection cum readout unit comprising a high precision impedance converter system that combines an on-board frequency generator with an analog-to-digital converter evaluation board, collectively interfaced with a central processor, calibration circuit, and smartphone. Employing a dispensed blood sample volume of 25 μL, the device is shown to have a sensitivity of 92 Ω/Hct and 287 Ω/Hb at an optimal frequency of 57 kHz. The respective linear response regimes appear to be wide enough to cover physiologically relevant limits, with excellent stability and reproducibility. Validation with clinical samples reveals limits of detection of Hct and Hb levels as low as 4.66% and 1.89 g dL^-1, respectively, which are beyond the quantitative capability of commonly used affordable point of care test kits. The envisaged paradigm of rapid, robust, highly accurate, energy-efficient, simple, user-friendly, multiplex portable detection, obviating any possible ambiguities in interpretation due to common artefacts of colorimetric detection technologies such as optical interference with the image analytical procedure due to the inherent redness of blood samples and background illumination, renders this ideal for deployment in resource-limited settings.

Smartphone-Integrated Label-Free Rapid Screening of Anemia from the Pattern Formed by One Drop of Blood on a Wet Paper Strip

Screening of anemic patients poses demanding challenges in extreme point-of-care settings where the gold standard diagnostic technologies are not pragmatic and the alternative point-of-care technologies suffer from compromised accuracy, prohibitive cost, process complexity, or reagent stability issues. As a disruption to this paradigm, here, we report the development of a smartphone-based sensor for rapid screening of anemic patients by exploiting the patterns formed by a spreading drop of blood on a wet paper strip wherein blood attempts to displace a more viscous fluid, on the porous matrix of a paper, leading to "finger-like" projections at the interface. We analyze the topological features of the pattern via smartphone-enabled image analytics and map the same with the relative occupancy of the red blood cells in the blood sample, allowing for label-free screening and classification of blood samples corresponding to moderate to severe anemic conditions. The accuracy of detection is verified by comparing with gold standard reports of hematology analyzer, showing a strong correlation coefficient (R²) of 0.975. This technique is likely to provide a crucial decision-making tool that obviates delicate reagents and skilled technicians for supreme functionality in resource-limited settings.

Sequential quantification of blood and diluent using red cell sedimentation-based separation and pressure-induced work in a microfluidic channel

The erythrocyte sedimentation method has been widely used to detect inflammatory diseases. However, this conventional method still has several drawbacks, such as a large blood volume (∼1 mL) and difficulty in continuous monitoring. Most importantly, image-based methods cannot quantify RBC-rich blood (blood) and RBC-free blood (diluent) simultaneously. In this study, instead of visualizing interface movement in the blood syringe, a simple method is proposed to quantify blood and diluent in microfluidic channels sequentially. The hematocrit was set to 25% to enhance RBC sedimentation and form two layers (blood and diluent) in the blood syringe. An air cavity (∼300 μL) inside the blood syringe was secured to completely remove dead volumes (∼200 μL) in fluidic paths (syringe needle and tubing). Thus, a small blood volume (V_b = 50 μL) suctioned into the blood syringe is sufficient for supplying blood and diluent in the blood channel sequentially. The relative ratio of blood resident time (RBC-to-diluent separation) was quantified using λ_b, which was obtained by quantifying the image intensity of blood flow. After the junction pressure (P_j) and blood volume (V) were obtained by analyzing the interface in the coflowing channel, the averaged work (W_p [Pa mm³]) was calculated and adopted to detect blood and diluent, respectively. The proposed method was then applied with various concentrations of dextran solution to detect aggregation-elevated blood. The W_p of blood and diluent exhibited substantial differences with respect to dextran solutions ranging from C_dex = 10 to C_dex = 40 mg mL^-1. Moreover, λ_b did not exhibit substantial differences in blood with C_dex > 10 mg mL^-1. The variations in λ_b were comparable to those of the previous method based on interface movement in the blood syringe. In conclusion, the W_P could detect blood as well as diluents more effectively than λ_b. Furthermore, the proposed method substantially reduced the blood volume from 1 mL to 50 μL.

Quantitative Monitoring of Dynamic Blood Flows Using Coflowing Laminar Streams in a Sensorless Approach

Determination of blood viscosity requires consistent measurement of blood flow rates, which leads to measurement errors and presents several issues when there are continuous changes in hematocrit changes. Instead of blood viscosity, a coflowing channel as a pressure sensor is adopted to quantify the dynamic flow of blood. Information on blood (i.e., hematocrit, flow rate, and viscosity) is not provided in advance. Using a discrete circuit model for the coflowing streams, the analytical expressions for four properties (i.e., pressure, shear stress, and two types of work) are then derived to quantify the flow of the test fluid. The analytical expressions are validated through numerical simulations. To demonstrate the method, the four properties are obtained using the present method by varying the flow patterns (i.e., constant flow rate or sinusoidal flow rate) as well as test fluids (i.e., glycerin solutions and blood). Thereafter, the present method is applied to quantify the dynamic flows of RBC aggregation-enhanced blood with a peristaltic pump, where any information regarding the blood is not specific. The experimental results indicate that the present method can quantify dynamic blood flow consistently, where hematocrit changes continuously over time.

Experimental Investigation of Air Compliance Effect on Measurement of Mechanical Properties of Blood Sample Flowing in Microfluidic Channels

Air compliance has been used effectively to stabilize fluidic instability resulting from a syringe pump. It has also been employed to measure blood viscosity under constant shearing flows. However, due to a longer time delay, it is difficult to quantify the aggregation of red blood cells (RBCs) or blood viscoelasticity. To quantify the mechanical properties of blood samples (blood viscosity, RBC aggregation, and viscoelasticity) effectively, it is necessary to quantify contributions of air compliance to dynamic blood flows in microfluidic channels. In this study, the effect of air compliance on measurement of blood mechanical properties was experimentally quantified with respect to the air cavity in two driving syringes. Under periodic on–off blood flows, three mechanical properties of blood samples were sequentially obtained by quantifying microscopic image intensity (<I>) and interface (α) in a co-flowing channel. Based on a differential equation derived with a fluid circuit model, the time constant was obtained by analyzing the temporal variations of β = 1/(1–α). According to experimental results, the time constant significantly decreased by securing the air cavity in a reference fluid syringe (~0.1 mL). However, the time constant increased substantially by securing the air cavity in a blood sample syringe (~0.1 mL). Given that the air cavity in the blood sample syringe significantly contributed to delaying transient behaviors of blood flows, it hindered the quantification of RBC aggregation and blood viscoelasticity. In addition, it was impossible to obtain the viscosity and time constant when the blood flow rate was not available. Thus, to measure the three aforementioned mechanical properties of blood samples effectively, the air cavity in the blood sample syringe must be minimized (V_{air, R} = 0). Concerning the air cavity in the reference fluid syringe, it must be sufficiently secured about V_{air, R} = 0.1 mL for regulating fluidic instability because it does not affect dynamic blood flows.

Impacts of low concentration surfactant on red blood cell dielectrophoretic responses

Cell dielectrophoretic responses have been extensively studied for biomarker expression, blood typing, sepsis, circulating tumor cell separations, and others. Surfactants are often added to the analytical buffer in electrokinetic cellular microfluidic systems to lower surface/interfacial tensions. In nonelectrokinetic systems, surfactants influence cell size, shape, and agglomeration; this has not been systematically documented in electrokinetic systems. In the present work, the impacts of the Triton X-100 surfactant on human red blood cells (RBCs) were explored via ultraviolet-visible spectroscopy (UV-Vis) and dielectrophoresis (DEP) to compare nonelectrokinetic and electrokinetic responses, respectively. The UV-Vis spectra of Triton X-100 treated RBCs were dramatically different from that of native RBCs. DEP responses of RBCs were compared to RBCs treated with low concentrations of Triton X-100 (0.07-0.17 mM) to ascertain surfactant effects on dielectric properties. A star-shaped electrode design was used to quantify RBC dielectric properties by fitting a single-shell oblate cell model to experimentally-derived DEP spectra. The presence of 0.07 and 0.11 mM of Triton X-100 shifted the RBC's DEP spectra yielding lower crossover frequencies ( f C O ) . The single-shell oblate model revealed that cell radius and membrane permittivity are the dominant influencers of DEP spectral shifts. The trends observed were similar for 0.11 mM and 0.07 mM Triton X-100 treated cells. However, a further increase of Triton X-100 to 0.17 mM caused cells to only exhibit negative DEP. The magnitude of the DEP force increased with Triton X-100 concentration. This work indicates that dynamic surfactant interactions with cell membranes alter cell dielectric responses and properties.

In vitro and ex vivo measurement of the biophysical properties of blood using microfluidic platforms and animal models

Haemorheologically impaired microcirculation, such as blood clotting or abnormal blood flow, causes interrupted blood flows in vascular networks. The biophysical properties of blood, including blood viscosity, blood viscoelasticity, haematocrit, red blood bell (RBC) aggregation, erythrocyte sedimentation rate and RBC deformability, have been used to monitor haematological diseases. In this review, we summarise several techniques for measuring haemorheological properties, such as blood viscosity, RBC deformability and RBC aggregation, using in vitro microfluidic platforms. Several methodologies for the measurement of haemorheological properties with the assistance of an extracorporeal rat bypass loop are also presented. We briefly discuss several emerging technologies for continuous, long-term, multiple measurements of haemorheological properties under in vitro or ex vivo conditions.

Quantitative Measurement and Evaluation of Red Blood Cell Aggregation in Normal Blood Based on a Modified Hanai Equation

The aggregation of red blood cells (RBCs) in normal blood (non-coagulation) has been quantitatively measured by blood pulsatile flow based on multiple-frequency electrical impedance spectroscopy. The relaxation frequencies f_c under static and flowing conditions of blood pulsatile flow are utilized to evaluate the RBC aggregation quantitatively with the consideration of blood flow factors (RBC orientation, deformation, thickness of electrical double layer (EDL)). Both porcine blood and bovine blood are investigated in experiments, for the reason that porcine blood easily forms RBC aggregates, while bovine blood does not. The results show that the relaxation frequencies f_c of porcine blood and bovine blood present opposite performance, which indicates that the proposed relaxation frequency f_c is efficient to measure RBCs aggregation. Furthermore, the modified Hanai equation is proposed to quantitatively calculate the influence of RBCs aggregation on relaxation frequency f_c. The study confirms the feasibility of a high speed, on-line RBC aggregation sensing method in extracorporeal circulation systems.

A Disposable Blood-on-a-Chip for Simultaneous Measurement of Multiple Biophysical Properties

Biophysical properties are widely used to detect pathophysiological processes of vascular diseases or clinical states. For early detection of cardiovascular diseases, it is necessary to simultaneously measure multiple biophysical properties in a microfluidic environment. However, a microfluidic-based technique for measuring multiple biophysical properties has not been demonstrated. In this study, a simple measurement method was suggested to quantify three biophysical properties of blood, including red blood cell (RBC) deformability, RBC aggregation, and hematocrit. To demonstrate the suggested method, a microfluidic device was constructed, being composed of a big-sized channel (BC), a parallel micropillar (MP), a main channel, a branch channel, inlet, and outlets. By operating a single syringe pump, blood was supplied into the inlet of the microfluidic device, at a periodic on-off profile (i.e., period = 240 s). The RBC deformability index (DI) was obtained by analyzing the averaged blood velocity in the branch channel. Additionally, the RBC aggregation index (AIN) and the hematocrit index (HiBC) were measured by analyzing the image intensity of blood flows in the MP and the BC, respectively. The corresponding contributions of three influencing factors, including the turn-on time (Ton), the amplitude of blood flow rate (Q₀), and the hematocrit (Hct) on the biophysical indices (DI, AIN, and HiBC) were evaluated quantitatively. As the three biophysical indices varied significantly with respect to the three factors, the following conditions (i.e., Ton = 210 s, Q₀ = 1 mL/h, and Hct = 50%) were maintained for consistent measurement of biophysical properties. The proposed method was employed to detect variations of biophysical properties depending on the concentrations of autologous plasma, homogeneous hardened RBCs, and heterogeneous hardened RBCs. Based on the observations, the proposed method exhibited significant differences in biophysical properties depending on base solutions, homogeneous hardened RBCs (i.e., all RBCs fixed with the same concentration of glutaraldehyde solution), and heterogeneous hardened RBCs (i.e., partially mixed with normal RBCs and homogeneous hardened RBCs). Additionally, the suggested indices (i.e., DI, AIN, and HiBC) were effectively employed to quantify three biophysical properties, including RBC deformability, RBC aggregation, and hematocrit.

Periodic and simultaneous quantification of blood viscosity and red blood cell aggregation using a microfluidic platform under in-vitro closed-loop circulation

To evaluate variations of blood circulating in closed loops, hemorheological properties including blood viscosity and red blood cells (RBCs) are quantitatively measured with independent in-vitro instruments after collecting blood from a closed loop. But, most previous methods require periodic blood collections which induce several problems such as geometric differences between the fluidic channel and the in-vitro method, hemodilution, storage time, and unspecific blood flow rates. To resolve these issues, in this study, blood viscosity and RBC aggregation of blood circulating within a closed loop are measured with a microfluidic platform periodically and simultaneously. To demonstrate the proposed method, in-vitro closed-loop circulation is established by connecting several components (peristaltic pump, air compliance unit, fluid divider, and reservoir) in series. In addition, to measure blood viscosity and RBC aggregation, a microfluidic platform composed of a microfluidic device, pinch valve, and syringe pump is created. During each period, blood viscosity and RBC aggregation are measured by monitoring blood flow at constant blood flow, and image intensity at stationary blood flow. The proposed method is first employed to evaluate the effect of hematocrits and dextran concentrations on the RBC aggregation and blood viscosity by using a syringe pump (i.e., specific blood flow-rate). The method is then applied to detect the blood viscosity and RBC aggregation under in-vitro closed-loop circulation (i.e., unspecific blood flow-rate). From these experimental demonstrations, it is found that the suggested method can be effectively used to monitor the RBC aggregation and blood viscosity under in-vitro closed-loop circulation. Since this method does not require periodic collection from closed-loop circulation or an additional procedure for estimating blood flow-rate with a syringe pump, it will be effectively used to monitor variations of blood circulating in extracorporeal bypass loops.

Acoustofluidic hematocrit determination

Hematocrit (HCT) measurements of blood from patients, blood donors and athletes are routinely performed on a daily basis. These measurements are often performed in centralized hospital labs by whole blood analyzers, which leads to long time-to-result. On site measurements, based on centrifugation can be done, but these assays require manual handling, are slow and can just measure HCT in contrast to the central lab whole blood analyzers. In this work, we present a microfluidic based method to measure HCT in blood samples by acoustic separation of whole blood into discrete regions of plasma and red blood cells. Comparison of the areas of the red blood cell and plasma regions gives an accurate HCT value, with a linear correlation to the centrifugation-based reference method. A readout can be performed within 2 s of acoustic actuation providing a readout accuracy of approximately 3% points (pp) HCT. Additional accuracy can be achieved by extending the acoustic actuation to 20 s, yielding an error of less than 1 pp HCT. This acoustic tool is optimal for integration into a lab-on-a-chip device with in-line measurements of different clinical parameters.

Microfluidic-Based Measurement Method of Red Blood Cell Aggregation under Hematocrit Variations

Red blood cell (RBC) aggregation and erythrocyte sedimentation rate (ESR) are considered to be promising biomarkers for effectively monitoring blood rheology at extremely low shear rates. In this study, a microfluidic-based measurement technique is suggested to evaluate RBC aggregation under hematocrit variations due to the continuous ESR. After the pipette tip is tightly fitted into an inlet port, a disposable suction pump is connected to the outlet port through a polyethylene tube. After dropping blood (approximately 0.2 mL) into the pipette tip, the blood flow can be started and stopped by periodically operating a pinch valve. To evaluate variations in RBC aggregation due to the continuous ESR, an EAI (Erythrocyte-sedimentation-rate Aggregation Index) is newly suggested, which uses temporal variations of image intensity. To demonstrate the proposed method, the dynamic characterization of the disposable suction pump is first quantitatively measured by varying the hematocrit levels and cavity volume of the suction pump. Next, variations in RBC aggregation and ESR are quantified by varying the hematocrit levels. The conventional aggregation index (AI) is maintained constant, unrelated to the hematocrit values. However, the EAI significantly decreased with respect to the hematocrit values. Thus, the EAI is more effective than the AI for monitoring variations in RBC aggregation due to the ESR. Lastly, the proposed method is employed to detect aggregated blood and thermally-induced blood. The EAI gradually increased as the concentration of a dextran solution increased. In addition, the EAI significantly decreased for thermally-induced blood. From this experimental demonstration, the proposed method is able to effectively measure variations in RBC aggregation due to continuous hematocrit variations, especially by quantifying the EAI.

Continuous and simultaneous measurement of the biophysical properties of blood in a microfluidic environment

A new measurement method is proposed to quantify blood viscosity, blood viscoelasticity, and RBC aggregation, in a continuous and simultaneous fashion.