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Leerson J, Tulloh A, Lopez FT, Gregory S, Buscher H, Rosengarten G. Detecting Oxygenator Thrombosis in ECMO: A Review of Current Techniques and an Exploration of Future Directions. Semin Thromb Hemost 2024; 50:253-270. [PMID: 37640048 DOI: 10.1055/s-0043-1772843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Extracorporeal membrane oxygenation (ECMO) is a life-support technique used to treat cardiac and pulmonary failure, including severe cases of COVID-19 (coronavirus disease 2019) involving acute respiratory distress syndrome. Blood clot formation in the circuit is one of the most common complications in ECMO, having potentially harmful and even fatal consequences. It is therefore essential to regularly monitor for clots within the circuit and take appropriate measures to prevent or treat them. A review of the various methods used by hospital units for detecting blood clots is presented. The benefits and limitations of each method are discussed, specifically concerning detecting blood clots in the oxygenator, as it is concluded that this is the most critical and challenging ECMO component to assess. We investigate the feasibility of solutions proposed in the surrounding literature and explore two areas that hold promise for future research: the analysis of small-scale pressure fluctuations in the circuit, and real-time imaging of the oxygenator. It is concluded that the current methods of detecting blood clots cannot reliably predict clot volume, and their inability to predict clot location puts patients at risk of thromboembolism. It is posited that a more in-depth analysis of pressure readings using machine learning could better provide this information, and that purpose-built imaging could allow for accurate, real-time clotting analysis in ECMO components.
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Affiliation(s)
- Jack Leerson
- Department is Manufacturing, Materials and Mechatronics Engineering, School of Engineering, RMIT University, Melbourne, Victoria, Australia
- Department of Manufacturing, CSIRO, Research Way, Clayton, Victoria, Australia
| | - Andrew Tulloh
- Department of Manufacturing, CSIRO, Research Way, Clayton, Victoria, Australia
| | - Francisco Tovar Lopez
- Department is Manufacturing, Materials and Mechatronics Engineering, School of Engineering, RMIT University, Melbourne, Victoria, Australia
| | - Shaun Gregory
- Department of Mechanical and Aerospace Engineering, Cardiorespiratory Engineering and Technology Laboratory, Monash University, Melbourne, Victoria, Australia
| | - Hergen Buscher
- Department of Intensive Care Medicine, St Vincent's Hospital, Sydney, Australia
| | - Gary Rosengarten
- Department is Manufacturing, Materials and Mechatronics Engineering, School of Engineering, RMIT University, Melbourne, Victoria, Australia
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Sun S, Ma Q, Sheng Q, Huang S, Wu C, Liu J, Xu J. Amyloid-β Oligomer-Induced Electrophysiological Mechanisms and Electrical Impedance Changes in Neurons. SENSORS (BASEL, SWITZERLAND) 2024; 24:1211. [PMID: 38400369 PMCID: PMC10892449 DOI: 10.3390/s24041211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/04/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
Amyloid plays a critical role in the pathogenesis of Alzheimer's disease (AD) and can aggregate to form oligomers and fibrils in the brain. There is increasing evidence that highly toxic amyloid-β oligomers (AβOs) lead to tau protein aggregation, hyperphosphorylation, neuroinflammation, neuronal loss, synaptic loss, and dysfunction. Although the effects of AβOs on neurons have been investigated using conventional biochemical experiments, there are no established criteria for electrical evaluation. To this end, we explored electrophysiological changes in mouse hippocampal neurons (HT22) following exposure to AβOs and/or naringenin (Nar, a flavonoid compound) using electrical impedance spectroscopy (EIS). AβO-induced HT22 showed a decreased impedance amplitude and increased phase angle, and the addition of Nar reversed these changes. The characteristic frequency was markedly increased with AβO exposure, which was also reversed by Nar. The AβOs decreased intranuclear and cytoplasmic resistance and increased nucleus resistance and extracellular capacitance. Overall, the innovative construction of the eight-element CPE-equivalent circuit model further reflects that the pseudo-capacitance of the cell membrane and cell nucleus was increased in the AβO-induced group. This study conclusively revealed that AβOs induce cytotoxic effects by disrupting the resistance characteristics of unit membranes. The results further support that EIS is an effective technique for evaluating AβO-induced neuronal damage and microscopic electrical distinctions in the sub-microscopic structure of reactive cells.
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Affiliation(s)
- Shimeng Sun
- Department of Physiology and Pharmacology, Health Science Center, Ningbo University, Ningbo 315211, China; (S.S.); (Q.M.); (Q.S.); (S.H.); (C.W.)
| | - Qing Ma
- Department of Physiology and Pharmacology, Health Science Center, Ningbo University, Ningbo 315211, China; (S.S.); (Q.M.); (Q.S.); (S.H.); (C.W.)
| | - Qiyu Sheng
- Department of Physiology and Pharmacology, Health Science Center, Ningbo University, Ningbo 315211, China; (S.S.); (Q.M.); (Q.S.); (S.H.); (C.W.)
| | - Shangwei Huang
- Department of Physiology and Pharmacology, Health Science Center, Ningbo University, Ningbo 315211, China; (S.S.); (Q.M.); (Q.S.); (S.H.); (C.W.)
| | - Chenxia Wu
- Department of Physiology and Pharmacology, Health Science Center, Ningbo University, Ningbo 315211, China; (S.S.); (Q.M.); (Q.S.); (S.H.); (C.W.)
| | - Junsong Liu
- State Key Laboratory of Superhard Materials, College of Physics, Jilin University, Changchun 130012, China
| | - Jia Xu
- Department of Physiology and Pharmacology, Health Science Center, Ningbo University, Ningbo 315211, China; (S.S.); (Q.M.); (Q.S.); (S.H.); (C.W.)
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Yao G, Ji F, Chen J, Dai B, Jia L. Nanobody-functionalized conduit with built-in static mixer for specific elimination of cytokines in hemoperfusion. Acta Biomater 2023; 172:260-271. [PMID: 37806373 DOI: 10.1016/j.actbio.2023.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/09/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
Removing excessively produced cytokines is of paramount significance in blood purification therapy for hypercytokinemia-associated diseases. In this study, we devised a conduit that is modified with nanobodies (Nb) and incorporates static mixers (Nb-SMC) to eliminate surplus cytokines from the bloodstream. The low-pressure-drop (LPD) static mixer, with each unit featuring two 90°-crossed blades, was strategically arranged in a tessellated pattern on the inner wall of the conduit to induce turbulent mixing effects during the flow of blood. This arrangement enhances mass transfer and molecular diffusion, thereby assisting in the identification and elimination of cytokines. By utilizing computational fluid dynamics (CFD) studies, the Nb-SMC was rationally designed and prepared, ensuring an optimal interval between two mixer units (H/G = 2.5). The resulting Nb-SMC exhibited a remarkable selective clearance of IL-17A, reaching up to 85 %. Additionally, the process of Nb immobilization could be adjusted to achieve the simultaneous removal of multiple cytokines from the bloodstream. Notably, our Nb-SMC displayed good blood compatibility without potential adverse effects on the composition of human blood. As the sole documented static mixer-integrated conduit capable of selectively eliminating cytokines at their physiological concentrations, it holds promise in the clinical potential for hypercytokinemia in high-risk patients. STATEMENT OF SIGNIFICANCE: High-efficient cytokines removal in critical care still remains a challenge. The conduit technique we proposed here is a brand-new strategy for cytokines removal in blood purification therapy. On the one hand, nanobody endows the conduit with specific recognition of cytokine, on the other hand, the build-in static mixer enhances the diffusion of antigenic cytokine to the ligand. The combination of these two has jointly achieved the efficient and specific removal of cytokine. This innovative material is the only reported artificial biomaterial capable of selectively eliminating multiple cytokines under conditions close to clinical practice. It has the potential to improve outcomes for patients with hypercytokinemia and reduce the risk of adverse events associated with current treatment modalities.
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Affiliation(s)
- Guangshuai Yao
- Liaoning Key Laboratory of Molecular Recognition and imaging, School of Bioengineering, Dalian University of Technology, No.2 Linggong Road, Dalian, Liaoning 116023, PR China
| | - Fangling Ji
- Liaoning Key Laboratory of Molecular Recognition and imaging, School of Bioengineering, Dalian University of Technology, No.2 Linggong Road, Dalian, Liaoning 116023, PR China
| | - Jiewen Chen
- Liaoning Key Laboratory of Molecular Recognition and imaging, School of Bioengineering, Dalian University of Technology, No.2 Linggong Road, Dalian, Liaoning 116023, PR China
| | - Bingbing Dai
- Department of Rheumatology and Immunology, Dalian Municipal Central Hospital affiliated with Dalian University of Technology, No.826, Xinan Road Dalian, 116033 Liaoning, PR China
| | - Lingyun Jia
- Liaoning Key Laboratory of Molecular Recognition and imaging, School of Bioengineering, Dalian University of Technology, No.2 Linggong Road, Dalian, Liaoning 116023, PR China.
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Zeibi Shirejini S, Carberry J, McQuilten ZK, Burrell AJC, Gregory SD, Hagemeyer CE. Current and future strategies to monitor and manage coagulation in ECMO patients. Thromb J 2023; 21:11. [PMID: 36703184 PMCID: PMC9878987 DOI: 10.1186/s12959-023-00452-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) can provide life-saving support for critically ill patients suffering severe respiratory and/or cardiac failure. However, thrombosis and bleeding remain common and complex problems to manage. Key causes of thrombosis in ECMO patients include blood contact to pro-thrombotic and non-physiological surfaces, as well as high shearing forces in the pump and membrane oxygenator. On the other hand, adverse effects of anticoagulant, thrombocytopenia, platelet dysfunction, acquired von Willebrand syndrome, and hyperfibrinolysis are all established as causes of bleeding. Finding safe and effective anticoagulants that balance thrombosis and bleeding risk remains challenging. This review highlights commonly used anticoagulants in ECMO, including their mechanism of action, monitoring methods, strengths and limitations. It further elaborates on existing anticoagulant monitoring strategies, indicating their target range, benefits and drawbacks. Finally, it introduces several highly novel approaches to real-time anticoagulation monitoring methods including sound, optical, fluorescent, and electrical measurement as well as their working principles and future directions for research.
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Affiliation(s)
- Saeedreza Zeibi Shirejini
- grid.1002.30000 0004 1936 7857NanoBiotechnology Laboratory, Central Clinical School, Australian Centre for Blood Diseases, Monash University, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857Cardiorespiratory Engineering and Technology Laboratory, Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC Australia
| | - Josie Carberry
- grid.1002.30000 0004 1936 7857Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC Australia
| | - Zoe K. McQuilten
- grid.1002.30000 0004 1936 7857Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, and Department of Clinical Haematology, Monash Health, Melbourne, VIC Australia
| | - Aidan J. C. Burrell
- grid.1623.60000 0004 0432 511XSchool of Medicine, Nursing, and Health Sciences, Clayton and Intensive Care Unit, Monash University, Alfred Hospital, Melbourne, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Epidemiology and Preventative Medicine, School of Public Health, Monash University, Melbourne, VIC Australia
| | - Shaun D. Gregory
- grid.1002.30000 0004 1936 7857Cardiorespiratory Engineering and Technology Laboratory, Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC Australia
| | - Christoph E. Hagemeyer
- grid.1002.30000 0004 1936 7857NanoBiotechnology Laboratory, Central Clinical School, Australian Centre for Blood Diseases, Monash University, Melbourne, VIC Australia
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Sifuna MW, Kawashima D, Matsuura K, Obara H, Nakajima Y, Takei M. Simultaneous electrical online estimation of changes in blood hematocrit and temperature in cardiopulmonary bypass. J Artif Organs 2022; 25:305-313. [PMID: 35254539 DOI: 10.1007/s10047-022-01320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
Abstract
Two equations have been developed from multi-frequency measurements of blood impedance Zb for a simultaneous electrical online estimation of changes in blood hematocrit ΔH [%] and temperatures ΔT [K] in cardiopulmonary bypass (CPB). Zb of fixed blood volumes at varying H and T were measured by an impedance analyzer and changes in blood conductivity σb and relative permittivity εb computed. Correlation analysis were based on changes in σb with H or T at f = 1 MHz while H and T equations were developed by correlating changes in εb with H and T at dual frequencies of f = 1 MHz and f = 10 MHz which best capture blood plasma Zp and red blood cell cytoplasm Zcyt impedances respectively. Results show high correlations between σb and H (R2 = 0.987) or σb and T (R2 = 0.9959) indicating dependence of the electrical parameters of blood on its H and T. Based on computed εb, changes in blood hematocrit ΔH and temperature ΔT at a given time t are estimated as ΔH(t) = 1.7298Δεb (f = 1 MHz) - 1.0669Δεb (f = 10 MHz) and ΔT(t) = -2.186Δεb (f = 1 MHz) + 2.13Δεb (f = 10 MHz). When applied to a CPB during a canine mitral valve plasty, ΔH and ΔT had correlations of R2 = 0.9992 and R2 = 0.966 against H and T respectively as measured by conventional devices.
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Affiliation(s)
- Martin Wekesa Sifuna
- Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Daisuke Kawashima
- Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan.
| | - Katsuhiro Matsuura
- VCA Japan Shiraishi Animal Hospital, 4 Chome-33-2, Saitama, Sayamadai, Sayama, 350-1304, Japan
- Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3Chome-8-1, Harumicho, Fuchu, Tokyo, 183-8538, Japan
| | - Hiromichi Obara
- Department of Mechanical System Engineering, Tokyo Metropolitan University, 6-6 Asahigaoka, Hino-shi, Tokyo, 191-0065, Japan
| | - Yusuke Nakajima
- Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Masahiro Takei
- Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan.
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Patil S, Darcourt J, Messina P, Bozsak F, Cognard C, Doyle K. Characterising acute ischaemic stroke thrombi: insights from histology, imaging and emerging impedance-based technologies. Stroke Vasc Neurol 2022; 7:353-363. [PMID: 35241632 PMCID: PMC9453827 DOI: 10.1136/svn-2021-001038] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 02/02/2022] [Indexed: 12/13/2022] Open
Abstract
Treatment of acute ischaemic stroke (AIS) focuses on rapid recanalisation of the occluded artery. In recent years, advent of mechanical thrombectomy devices and new procedures have accelerated the analysis of thrombi retrieved during the endovascular thrombectomy procedure. Despite ongoing developments and progress in AIS imaging techniques, it is not yet possible to conclude definitively regarding thrombus characteristics that could advise on the probable efficacy of thrombolysis or thrombectomy in advance of treatment. Intraprocedural devices with dignostic capabilities or new clinical imaging approaches are needed for better treatment of AIS patients. In this review, what is known about the composition of the thrombi that cause strokes and the evidence that thrombus composition has an impact on success of acute stroke treatment has been examined. This review also discusses the evidence that AIS thrombus composition varies with aetiology, questioning if suspected aetiology could be a useful indicator to stroke physicians to help decide the best acute course of treatment. Furthermore, this review discusses the evidence that current widely used radiological imaging tools can predict thrombus composition. Further use of new emerging technologies based on bioimpedance, as imaging modalities for diagnosing AIS and new medical device tools for detecting thrombus composition in situ has been introduced. Whether bioimpedance would be beneficial for gaining new insights into in situ thrombus composition that could guide choice of optimum treatment approach is also reviewed.
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Affiliation(s)
- Smita Patil
- CÚRAM, SFI Research Centre for Medical Devices, National University of Ireland Galway, Galway, Ireland
| | | | | | | | | | - Karen Doyle
- CÚRAM, SFI Research Centre for Medical Devices, National University of Ireland Galway, Galway, Ireland .,Physiology, National University of Ireland Galway, Galway, Ireland
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Bao H, Li J, Wen J, Cheng L, Hu Y, Zhang Y, Wan N, Takei M. Quantitative Evaluation of Burn Injuries Based on Electrical Impedance Spectroscopy of Blood with a Seven-Parameter Equivalent Circuit. SENSORS 2021; 21:s21041496. [PMID: 33670072 PMCID: PMC7926917 DOI: 10.3390/s21041496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
A quantitative and rapid burn injury detection method has been proposed based on the electrical impedance spectroscopy (EIS) of blood with a seven-parameter equivalent circuit. The degree of burn injury is estimated from the electrical impedance characteristics of blood with different volume proportions of red blood cells (RBCs) and heated red blood cells (HRBCs). A quantitative relationship between the volume portion HHCT of HRBCs and the electrical impedance characteristics of blood has been demonstrated. A seven -parameter equivalent circuit is employed to quantify the relationship from the perspective of electricity. Additionally, the traditional Hanai equation has been modified to verify the experimental results. Results show that the imaginary part of impedance ZImt under the characteristic frequency (fc) has a linear relationship with HHCT which could be described by ZImt = −2.56HHCT − 2.01 with a correlation coefficient of 0.96. Moreover, the relationship between the plasma resistance Rp and HHCT is obtained as Rp = −7.2HHCT + 3.91 with a correlation coefficient of 0.96 from the seven -parameter equivalent circuit. This study shows the feasibility of EIS in the quantitative detection of burn injury by the quantitative parameters ZImt and Rp, which might be meaningful for the follow-up clinical treatment for burn injury.
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Affiliation(s)
- Huilu Bao
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
| | - Jianping Li
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
- Correspondence:
| | - Jianming Wen
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
| | - Li Cheng
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
| | - Yili Hu
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
| | - Yu Zhang
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
| | - Nen Wan
- The Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua 321004, China; (H.B.); (J.W.); (L.C.); (Y.H.); (Y.Z.); (N.W.)
| | - Masahiro Takei
- Graduate School of Mechanical Engineering, Division of Artificial System Science, Chiba University, 1-33 Yayoi, Inage, Chiba 263-8522, Japan;
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Morita N, Sakota D, Oota-Ishigaki A, Kosaka R, Maruyama O, Nishida M, Kondo K, Takeshita T, Iwasaki W. Real-time, non-invasive thrombus detection in an extracorporeal circuit using micro-optical thrombus sensors. Int J Artif Organs 2020; 44:565-573. [PMID: 33300399 PMCID: PMC8366175 DOI: 10.1177/0391398820978656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: Real-time, non-invasive monitoring of thrombus formation in extracorporeal circuits has yet to be achieved. To address the challenges of conventional optical thrombus detection methods requiring large devices that limit detection capacity, we developed a micro-optical thrombus sensor. Methods: The proposed micro-optical thrombus sensor can detect the intensity of light scattered by blood at wavelengths of 660 and 855 nm. Two thrombus sensors were installed on in vitro circuit: one at the rotary blood pump and one at a flow channel. To evaluate the variation in the ratio of incident light intensity at each wavelength of the two sensors, Rfluct (for 660 nm) and Ifluct (for 855 nm) were defined. Using fresh porcine blood as a working fluid, we performed in vitro tests of haematocrit (Hct) and oxygen saturation (SaO2) variation and thrombus detection. Thrombus tests were terminated after Rfluct or Ifluct showed a larger change than the maximum range of those in the Hct and SaO2 variation test. Results: In all three thrombus detection tests, Ifluct showed a larger change than the maximum range of those in the Hct and SaO2 variation test. After the tests, thrombus formation was confirmed in the pump, and there was no thrombus in the flow channel. The results indicate that Ifluct is an effective parameter for identifying the presence of a thrombus. Conclusion: Thrombus detection in an extracorporeal circuit using the developed micro-optical sensors was successfully demonstrated in an in vitro test.
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Affiliation(s)
- Nobutomo Morita
- Sensing System Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tosu, Saga, Japan
| | - Daisuke Sakota
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Akiko Oota-Ishigaki
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Ryo Kosaka
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Osamu Maruyama
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Masahiro Nishida
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Kazuki Kondo
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Toshihiro Takeshita
- Sensing System Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tosu, Saga, Japan
| | - Wataru Iwasaki
- Sensing System Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tosu, Saga, Japan
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9
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Plasma skimming efficiency of human blood in the spiral groove bearing of a centrifugal blood pump. J Artif Organs 2020; 24:126-134. [PMID: 33113050 PMCID: PMC8154837 DOI: 10.1007/s10047-020-01221-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/13/2020] [Indexed: 11/15/2022]
Abstract
This work investigates the plasma skimming effect in a spiral groove bearing within a hydrodynamically levitated centrifugal blood pump when working with human blood having a hematocrit value from 0 to 40%. The present study assessed the evaluation based on a method that clarified the limitations associated with such assessments. Human blood was circulated in a closed-loop circuit via a pump operating at 4000 rpm at a flow rate of 5 L/min. Red blood cells flowing through a ridge area of the bearing were directly observed using a high-speed microscope. The hematocrit value in the ridge area was calculated using the mean corpuscular volume, the bearing gap, the cross-sectional area of a red blood cell, and the occupancy of red blood cells. The latter value was obtained from photographic images by dividing the number of pixels showing red blood cells in the evaluation area by the total number of pixels in this area. The plasma skimming efficiency was calculated as the extent to which the hematocrit of the working blood was reduced in the ridge area. For the hematocrit in the circuit from 0 to 40%, the plasma skimming efficiency was approximately 90%, meaning that the hematocrit in the ridge area became 10% as compared to that in the circuit. For a hematocrit of 20% and over, red blood cells almost completely occupied the ridge. Thus, a valid assessment of plasma skimming was only possible when the hematocrit was less than 20%.
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Namgung B, Lee T, Tan JKS, Poh DKH, Park S, Chng KZ, Agrawal R, Park SY, Leo HL, Kim S. Vibration motor-integrated low-cost, miniaturized system for rapid quantification of red blood cell aggregation. LAB ON A CHIP 2020; 20:3930-3937. [PMID: 32966494 DOI: 10.1039/d0lc00619j] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Human red blood cells (RBCs) aggregate under low shear conditions, which significantly modulates flow resistance and tissue perfusion. A higher aggregation tendency in blood thus serves as an important clinical indicator for the screening of cardiovascular disorders. Conventional ways of measuring RBC aggregation still require large sample volumes, cumbersome manual procedures, and expensive benchtop systems. These inconvenient and high-cost measurement methods hamper their clinical applicability. Here, we propose a low-cost, miniaturized system to overcome the limitations of these methods. Our system utilizes a coin vibration motor (CVM) to generate a localized vortex for disaggregating RBCs in a disposable fluidic chip. The design of the chip was optimized with fluid dynamics simulations to ensure sufficient shear flow in the localized vortex for RBC disaggregation. The time-dependent increase in light transmittance from an LED light source through the plasma gap while the RBCs re-aggregate is captured with a CMOS camera under stasis conditions to quantify the level of RBC aggregation. Our CVM-based aggregometer was validated against a commercial benchtop system for human blood samples under physiological and pathological conditions, and showed an excellent performance with a high intraclass correlation coefficient of 0.995. In addition, we were able to achieve a rapid measurement (<4 min) with the CVM-based aggregometer, requiring only a 6 μl blood sample. These illustrate the potential of our CVM-based aggregometer for low-cost point-of-care diagnostics without compromising the measurement sensitivity.
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Affiliation(s)
- Bumseok Namgung
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore.
| | - Taewoo Lee
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore.
| | - Justin Kok Soon Tan
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore. and Institute for Health Innovation and Technology, National University of Singapore, 117599, Singapore
| | - Daren Kiat How Poh
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore.
| | - Soyeon Park
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore. and Institute for Health Innovation and Technology, National University of Singapore, 117599, Singapore
| | - Kevin Ziyang Chng
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore. and Institute for Health Innovation and Technology, National University of Singapore, 117599, Singapore
| | - Rupesh Agrawal
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 308433, Singapore
| | - Sung-Yong Park
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore.
| | - Sangho Kim
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore. and Institute for Health Innovation and Technology, National University of Singapore, 117599, Singapore and The N.1 Institute for Health, National University of Singapore, 117456, Singapore
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Kawashima D, Li S, Obara H, Takei M. Low-Frequency Impedance-Based Cell Discrimination Considering Ion Transport Model in Cell Suspension. IEEE Trans Biomed Eng 2020; 68:1015-1023. [PMID: 32746028 DOI: 10.1109/tbme.2020.3002980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Low-frequency impedance-based (LFI) cell discrimination as a novel non-destructive and non-invasive cell discrimination is proposed. LFI cell discrimination discriminates the cell type by considering an ion transport model in cell suspension. Ion transport model in cell suspension is constructed on the basis of Fick's laws of diffusion in the extracellular region under ion permeability P which represents the characteristics of cell type. P is achieved using the ion transport model equation through an iterative curve fitting to an ion concentration in extracellular region obtained from low-frequency impedance which is assumed to be linearly related to the ion concentration in extracellular region. In experiment, the electrical impedance spectra from the frequency of 200 kHz to 2.0 MHz are measured over time during producing ions from intracellular region to extracellular one in cell suspension using an impedance analyzer and an interdigitated array electrode system. As a target cell type, two different cell types based on Medical Research Council 5 (MRC-5), which are different in intracellular component are used. The curve fitting is performed for the low-frequency impedance at 200 kHz at which impedance reflects the ion concentration in extracellular region in order to obtain P of each cell type. As a result, each cell type has its own P. The proposed LFI cell discrimination successfully discriminates the cell type.
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Sifuna MW, Koishi M, Uemura T, Tatekawa H, Haneishi H, Sapkota A, Takei M. Connector sensors for permittivity-based thrombus monitoring in extracorporeal life support. J Artif Organs 2020; 24:15-21. [PMID: 32638141 DOI: 10.1007/s10047-020-01190-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 06/23/2020] [Indexed: 11/26/2022]
Abstract
Extracorporeal circulation is vital in cardiovascular surgery, but thrombus formation at connector interface is a major threat. Optical coherence tomography (OCT) is presently used to monitor thrombogenesis at connectors, but it is expensive to install and complex to use. This study fabricated and evaluated a connector sensor for real-time permittivity-based thrombus monitoring at tube-connector interface. Computational simulations were initially done to pre-evaluate the applicability of connector sensor. The sensor was fabricated by incorporating two stainless steel electrodes on acrylic tube for measuring permittivity changes at the tube-connector interface. OCT images were also taken from the interface at intervals for comparisons. Results show that the sensor was able to detect thrombus formation at the interface in form of sudden rise in permittivity after time t = 9 min. The permittivity changes were confirmed by OCT images which showed thrombus formation after time t = 14 min implying that permittivity changes were due to regional aggregation of red blood cells. The connector sensor is therefore envisioned as an affordable alternative to OCT for real-time permittivity-based monitoring of thrombogenesis at tube-connector interface.
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Affiliation(s)
- Martin W Sifuna
- Division of Fundamental Engineering, Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Madoka Koishi
- Division of Fundamental Engineering, Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Takuo Uemura
- Division of Fundamental Engineering, Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Hanako Tatekawa
- Department of Medical Engineering, Graduate School of Science and Engineering, Chiba University, Chiba, 263-8522, Japan
| | - Hideaki Haneishi
- Center for Frontier Medical Engineering, Chiba University, Chiba, 263-8522, Japan
| | - Achyut Sapkota
- Department of Information and Computer Engineering, National Institute of Technology, Kisarazu College, 2-11-1 Kiyomidai-Higashi, Kisarazu, Chiba, 292-0041, Japan.
| | - Masahiro Takei
- Division of Fundamental Engineering, Department of Mechanical Engineering, Graduate School of Science and Engineering, Chiba University, 1-33, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
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13
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Sifuna MW, Baidillah MR, Sapkota A, Takei M. A Cole‐Cole Dielectric Relaxation Analysis of Albumin and γ‐Globulins for Protein Quantification by Electrical Impedance Spectroscopy. ELECTROANAL 2020. [DOI: 10.1002/elan.201900576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Martin Wekesa Sifuna
- Department of Mechanical Engineering, Graduate School of Engineering and Science, Div. Fundamental Engineering Chiba University 1-33, Inage-ku, Chiba-shi Chiba 263-8522 Japan
| | - Marlin Ramadhan Baidillah
- Department of Mechanical Engineering, Graduate School of Engineering and Science, Div. Fundamental Engineering Chiba University 1-33, Inage-ku, Chiba-shi Chiba 263-8522 Japan
| | - Achyut Sapkota
- Department of Information and Computer Engineering, National Institute of Technology Kisarazu College 2-11-1 Kiyomidai-Higashi, Kisarazu 292-0041 Chiba Japan E-mai.l
| | - Masahiro Takei
- Department of Mechanical Engineering, Graduate School of Engineering and Science, Div. Fundamental Engineering Chiba University 1-33, Inage-ku, Chiba-shi Chiba 263-8522 Japan
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Li J, Wan N, Wen J, Cheng G, He L, Cheng L. Quantitative detection and evaluation of thrombus formation based on electrical impedance spectroscopy. Biosens Bioelectron 2019; 141:111437. [PMID: 31279177 DOI: 10.1016/j.bios.2019.111437] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 01/13/2023]
Abstract
Thrombus formation is quantitatively measured and evaluated by the electrical impedance spectroscopy method in this study, which confirms the possibility for the application of a promising non-invasive thrombus detection method. The impedance parameter Z*(t) of blood from the electrical impedance spectroscopy is utilized to elaborate the impedance performance of blood during thrombus formation process. Experimental results indicate that the impedance Z*(t) of blood has regular variations under the formation of thrombus, which could be divided into three stages. Modified Hanai equation is proposed to quantitatively expound the three stages of impedance Z*(t) variation. The amount of fibrin and thrombus clot is founded to be accounted for the impedance variation of blood, which confirms the feasibility and theoretical basis of the non-invasive and on-line thrombus bio-detection technology for patients with serious cardiovascular disease.
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Affiliation(s)
- Jianping Li
- Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua, 321004, Zhejiang Province, China
| | - Nen Wan
- Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua, 321004, Zhejiang Province, China.
| | - Jianming Wen
- Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua, 321004, Zhejiang Province, China
| | - Guangming Cheng
- Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua, 321004, Zhejiang Province, China
| | - Lidong He
- Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua, 321004, Zhejiang Province, China
| | - Li Cheng
- Institute of Precision Machinery and Smart Structure, College of Engineering, Zhejiang Normal University, Jinhua, 321004, Zhejiang Province, China
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Quantitative Measurement and Evaluation of Red Blood Cell Aggregation in Normal Blood Based on a Modified Hanai Equation. SENSORS 2019; 19:s19051095. [PMID: 30836669 PMCID: PMC6427202 DOI: 10.3390/s19051095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 02/06/2023]
Abstract
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 fc 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 fc of porcine blood and bovine blood present opposite performance, which indicates that the proposed relaxation frequency fc is efficient to measure RBCs aggregation. Furthermore, the modified Hanai equation is proposed to quantitatively calculate the influence of RBCs aggregation on relaxation frequency fc. The study confirms the feasibility of a high speed, on-line RBC aggregation sensing method in extracorporeal circulation systems.
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Linear relationship between cytoplasm resistance and hemoglobin in red blood cell hemolysis by electrical impedance spectroscopy & eight-parameter equivalent circuit. Biosens Bioelectron 2018; 119:103-109. [DOI: 10.1016/j.bios.2018.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/01/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022]
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