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

Quantification of Blood Viscoelasticity under Microcapillary Blood Flow

Blood elasticity is quantified using a single compliance model by analyzing pulsatile blood flow. However, one compliance coefficient is influenced substantially by the microfluidic system (i.e., soft microfluidic channels and flexible tubing). The novelty of the present method comes from the assessment of two distinct compliance coefficients, one for the sample and one for the microfluidic system. With two compliance coefficients, the viscoelasticity measurement can be disentangled from the influence of the measurement device. In this study, a coflowing microfluidic channel was used to estimate blood viscoelasticity. Two compliance coefficients were suggested to denote the effects of the polydimethylsiloxane (PDMS) channel and flexible tubing (C₁), as well as those of the RBC (red blood cell) elasticity (C₂), in a microfluidic system. On the basis of the fluidic circuit modeling technique, a governing equation for the interface in the coflowing was derived, and its analytical solution was obtained by solving the second-order differential equation. Using the analytic solution, two compliance coefficients were obtained via a nonlinear curve fitting technique. According to the experimental results, C₂/C₁ is estimated to be approximately 10.9-20.4 with respect to channel depth (h = 4, 10, and 20 µm). The PDMS channel depth contributed simultaneously to the increase in the two compliance coefficients, whereas the outlet tubing caused a decrease in C₁. The two compliance coefficients and blood viscosity varied substantially with respect to homogeneous hardened RBCs or heterogeneous hardened RBCs. In conclusion, the proposed method can be used to effectively detect changes in blood or microfluidic systems. In future studies, the present method can contribute to the detection of subpopulations of RBCs in the patient's blood.

Microfluidic techniques for mechanical measurements of biological samples

The use of microfluidics to make mechanical property measurements is increasingly common. Fabrication of microfluidic devices has enabled various types of flow control and sensor integration at micrometer length scales to interrogate biological materials. For rheological measurements of biofluids, the small length scales are well suited to reach high rates, and measurements can be made on droplet-sized samples. The control of flow fields, constrictions, and external fields can be used in microfluidics to make mechanical measurements of individual bioparticle properties, often at high sampling rates for high-throughput measurements. Microfluidics also enables the measurement of bio-surfaces, such as the elasticity and permeability properties of layers of cells cultured in microfluidic devices. Recent progress on these topics is reviewed, and future directions are discussed.

Advances in Microfluidics for Single Red Blood Cell Analysis

The utilizations of microfluidic chips for single RBC (red blood cell) studies have attracted great interests in recent years to filter, trap, analyze, and release single erythrocytes for various applications. Researchers in this field have highlighted the vast potential in developing micro devices for industrial and academia usages, including lab-on-a-chip and organ-on-a-chip systems. This article critically reviews the current state-of-the-art and recent advances of microfluidics for single RBC analyses, including integrated sensors and microfluidic platforms for microscopic/tomographic/spectroscopic single RBC analyses, trapping arrays (including bifurcating channels), dielectrophoretic and agglutination/aggregation studies, as well as clinical implications covering cancer, sepsis, prenatal, and Sickle Cell diseases. Microfluidics based RBC microarrays, sorting/counting and trapping techniques (including acoustic, dielectrophoretic, hydrodynamic, magnetic, and optical techniques) are also reviewed. Lastly, organs on chips, multi-organ chips, and drug discovery involving single RBC are described. The limitations and drawbacks of each technology are addressed and future prospects are discussed.

Biosensing of Haemorheological Properties Using Microblood Flow Manipulation and Quantification

The biomechanical properties of blood have been used to detect haematological diseases and disorders. The simultaneous measurement of multiple haemorheological properties has been considered an important aspect for separating the individual contributions of red blood cells (RBCs) and plasma. In this study, three haemorheological properties (viscosity, time constant, and RBC aggregation) were obtained by analysing blood flow, which was set to a square-wave profile (steady and transient flow). Based on a simplified differential equation derived using a discrete circuit model, the time constant for viscoelasticity was obtained by solving the governing equation rather than using the curve-fitting technique. The time constant (λ) varies linearly with respect to the interface in the coflowing channel (β). Two parameters (i.e., average value: <λ>, linear slope: dλdβ) were newly suggested to effectively represent linearly varying time constant. <λ> exhibited more consistent results than dλdβ. To detect variations in the haematocrit in blood, we observed that the blood viscosity (i.e., steady flow) is better than the time constant (i.e., transient flow). The blood viscosity and time constant exhibited significant differences for the hardened RBCs. The present method was then successfully employed to detect continuously varying haematocrit resulting from RBC sedimentation in a driving syringe. The present method can consistently detect variations in blood in terms of the three haemorheological properties.

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.

A Review of Microfluidic Devices for Rheological Characterisation

The rheological characterisation of liquids finds application in several fields ranging from industrial production to the medical practice. Conventional rheometers are the gold standard for the rheological characterisation; however, they are affected by several limitations, including high costs, large volumes required and difficult integration to other systems. By contrast, microfluidic devices emerged as inexpensive platforms, requiring a little sample to operate and fashioning a very easy integration into other systems. Such advantages have prompted the development of microfluidic devices to measure rheological properties such as viscosity and longest relaxation time, using a finger-prick of volumes. This review highlights some of the microfluidic platforms introduced so far, describing their advantages and limitations, while also offering some prospective for future works.

Blood rheometer based on microflow manipulation of continuous blood flows using push-and-back mechanism

To understand the contributions of rheological properties to microcirculation, the simultaneous measurement of multiple rheological properties under continuous blood flows has been emphasized. However, existing methods exhibit limitations in terms of continuous and simultaneous monitoring. In this study, a simple method is suggested for simultaneously measuring four rheological properties (i.e., red blood cell (RBC) aggregation, blood viscosity, blood junction pressure, and RBC sedimentation) under a continuous blood flow. Using the push-and-back mechanism, which comprises a co-flowing channel, a test chamber, and an air compliance unit (ACU), blood is supplied to the test chamber and restored into the co-flowing channel periodically and reversely. First, RBC aggregation is quantified based on the intensity of the blood image in the test chamber. Second, blood viscosity and blood junction pressure are determined by analyzing the interface in the co-flowing channel. Lastly, RBC sedimentation is evaluated by analyzing the intensity of the blood image in the blood chamber. Based on quantitative studies involving several vital factors, the tubing length of ACU is set to L = 30 mm. The reference fluid (glycerin [20%]) is controlled in a periodic on-off manner (period = 240 s, and flow rate = 1 mL h^-1). The blood flow rate is maintained at 1 mL h^-1. Subsequently, the present method is used to determine the rheological properties of several blood samples with different hematocrits or diluents. Compared with previous studies, the present method yields sufficiently consistent trends with respect to the hematocrit level or concentration of dextran solution. The experimental results imply that the present method enables simultaneous and consistent measurements of four rheological properties of blood under continuous blood flows. This method can be regarded as a promising method for monitoring multiple rheological properties of blood circulating under an in vitro closed fluidic circuit.

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.

Standardization for obtaining blood viscosity: A systematic review

INTRODUCTION

There is evidence to suggest that blood viscosity (BV) is involved in several pathological processes. In this review, we evaluated the different methods of BV acquisition, analyzing the sample storage time, the storage temperature, the acquisition time, the acquisition temperature, sample volume, and shear rates, in order to standardize this technique.

METHODS

We selected 50 articles with methods of obtaining BV, evaluating pathologies through BV, comparing rheological equipment, monitoring, and regulating BV.

RESULTS AND CONCLUSION

Measurements should be obtained as soon as possible, to reduce hemorheological changes. It is necessary to refrigerate them at 4°C when the storage time is long. The acquisition time is related to the equipment used. BV measurements at 37°C will represent the real BV in vivo more faithfully. In order to understand the BV phenomena, the shear rates must be between 0.1 and 1000 s-1. There is a wide variety of equipment available for measuring the BV.

Microfluidic Quantification of Blood Pressure and Compliance Properties Using Velocity Fields under Periodic On–Off Blood Flows

To monitor variations of blood samples effectively, it is required to quantify static and dynamic properties simultaneously. With previous approaches, the viscosity and elasticity of blood samples are obtained for static and transient flows with two syringe pumps. In this study, simultaneous measurement of pressure and equivalent compliance is suggested by analyzing the velocity fields of blood flows, where a blood sample is delivered in a periodic on-off fashion with a single syringe pump. The microfluidic device is composed of a main channel (mc) for quantifying the equivalent compliance and a pressure channel (pc) for measuring the blood pressure. Based on the mathematical relation, blood pressure at junction (Px) is expressed as Px = kβ. Here, β is calculated by integrating the averaged velocity in the pressure channel (<Upc>). The equivalent compliance (Ceq) is then quantified as Ceq = λoff · Q0/Px with a discrete fluidic model. The time constant (λoff ) is obtained from the transient behavior of the averaged blood velocity in the main channel (<Umc>). According to results, Px and Ceq varied considerably with respect to the hematocrit and flow rate. The present method (i.e., blood pressure, compliance) shows a strong correlation with the previous method (i.e., blood viscosity, elasticity). In conclusion, the present method can be considered as a potential tool for monitoring the mechanical properties of blood samples supplied periodically from a single syringe pump.

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.

Ultrasound Standing Wave-Based Cell-to-liquid Separation for Measuring Viscosity and Aggregation of Blood Sample

When quantifying mechanical properties of blood samples flowing in closed fluidic circuits, blood samples are collected at specific intervals. Centrifugal separation is considered as a required procedure for preparing blood samples. However, the use of centrifuge is associated with several issues, including the potential for red blood cell (RBC) lysis, clotting activation, and RBC adhesions in the tube. In this study, an ultrasonic transducer is employed to separate RBCs or diluent from blood sample. The ultrasonic radiation force is much smaller than the centrifugal force acting in centrifuge, it can avoid critical issues occurring under centrifuge. Then, the RBC aggregation and blood viscosity of the blood sample are obtained using the microfluidic technique. According to the numerical results, ultrasonic transducers exhibited a maximum quality factor at an excitation frequency of 2.1 MHz. Periodic pattern of acoustic pressure fields were visualized experimentally as a column mode. The half wavelength obtained was as 0.5 λ = 0.378 ± 0.07 mm. The experimental results agreed with the analytical estimation sufficiently. An acoustic power of 2 W was selected carefully for separating RBCs or diluent from various blood samples (i.e., Hct = 20% ~ 50%; diluent: plasma, 1x phosphate-buffered saline (PBS), and dextran solution). The present method was employed to separate fixed blood samples which tended to stack inside the tube while using the centrifuge. Fixed RBCs were collected easily with an ultrasonic transducer. After various fixed blood samples with different base solutions (i.e., glutaraldehyde solution, 1x PBS, and dextran solution) were prepared using the present method, RBC aggregation and the viscosity of the blood sample are successfully obtained. In the near future, the present method will be integrated into ex vivo or in vitro fluidic circuit for measuring multiple mechanical properties of blood samples for a certain longer period.

Simultaneous measurement method of erythrocyte sedimentation rate and erythrocyte deformability in resource-limited settings

OBJECTIVE

The individual effects of plasma and red blood cells (RBCs) on the biophysical properties of blood can be monitored by measuring the erythrocyte sedimentation rate (ESR) and RBC deformability simultaneously. However, the previous methods require bulky and expensive facilities (i.e. microscope, high-speed camera, and syringe pump) to deliver blood or capture blood flows.

APPROACH

To resolve these issues, a simple method for sequential measurement of the ESR and RBC deformability is demonstrated by quantifying the cell-free volume (V _CF ), cell-rich volume (V _CR ), and blood volume (V _B ) inside an air-compressed syringe (ACS). A microfluidic device consists of multiple micropillar channels, an inlet, and outlet. After the ACS is filled with air (V _air   =  0.4 ml) and a blood sample (V _B   =  0.6 ml, hematocrit  =  30%) sequentially, the ACS is fitted into the inlet. The cavity inside the ACS is compressed to V _comp   =  0.4 ml after closing the outlet with a stopper. A smartphone camera is employed to capture variations in the V _CF , V _CR , and V _B inside the ACS. The ESR index suggested in this study (ESR _PM ) is obtained by dividing the V _CF (t  =  t ₁) with an elapse of t ₁. By removing the stopper, ΔV _B (ΔV _B   =  V _B [t  =  t ₁]  -  V _B ) is obtained and fitted as a two-term exponential model ([Formula: see text]. As a performance demonstration, the proposed method is employed to detect an ESR-enhanced blood sample, homogeneous hardened blood sample, and heterogeneous blood sample.

MAIN RESULTS

From the experimental results, it is found that the proposed method has the ability to detect various bloods by quantifying the ESR _PM and two coefficients (a, b) simultaneously.

SIGNIFICANCE

In conclusion, the present method can be effectively used to measure the ESR and RBC deformability in resource-limited settings.

Blood Viscoelasticity Measurement Using Interface Variations in Coflowing Streams under Pulsatile Blood Flows

Blood flows in microcirculation are determined by the mechanical properties of blood samples, which have been used to screen the status or progress of diseases. To achieve this, it is necessary to measure the viscoelasticity of blood samples under a pulsatile blood condition. In this study, viscoelasticity measurement is demonstrated by quantifying interface variations in coflowing streams. To demonstrate the present method, a T-shaped microfluidic device is designed to have two inlets (a, b), one outlet (a), two guiding channels (blood sample channel, reference fluid channel), and one coflowing channel. Two syringe pumps are employed to infuse a blood sample at a sinusoidal flow rate. The reference fluid is supplied at a constant flow rate. Using a discrete fluidic circuit model, a first-order linear differential equation for the interface is derived by including two approximate factors (F₁ = 1.094, F₂ = 1.1087). The viscosity and compliance are derived analytically as viscoelasticity. The experimental results showed that compliance is influenced substantially by the period. The hematocrit and diluent contributed to the varying viscosity and compliance. The viscoelasticity varied substantially for red blood cells fixed with higher concentrations of glutaraldehyde solution. The experimental results showed that the present method has the ability to monitor the viscoelasticity of blood samples under a sinusoidal flow-rate pattern.

Microfluidic-Based Biosensor for Blood Viscosity and Erythrocyte Sedimentation Rate Using Disposable Fluid Delivery System

To quantify the variation of red blood cells (RBCs) or plasma proteins in blood samples effectively, it is necessary to measure blood viscosity and erythrocyte sedimentation rate (ESR) simultaneously. Conventional microfluidic measurement methods require two syringe pumps to control flow rates of both fluids. In this study, instead of two syringe pumps, two air-compressed syringes (ACSs) are newly adopted for delivering blood samples and reference fluid into a T-shaped microfluidic channel. Under fluid delivery with two ACS, the flow rate of each fluid is not specified over time. To obtain velocity fields of reference fluid consistently, RBCs suspended in 40% glycerin solution (hematocrit = 7%) as the reference fluid is newly selected for avoiding RBCs sedimentation in ACS. A calibration curve is obtained by evaluating the relationship between averaged velocity obtained with micro-particle image velocimetry (μPIV) and flow rate of a syringe pump with respect to blood samples and reference fluid. By installing the ACSs horizontally, ESR is obtained by monitoring the image intensity of the blood sample. The averaged velocities of the blood sample and reference fluid (<U_B>, <U_R>) and the interfacial location in both fluids (α_B) are obtained with μPIV and digital image processing, respectively. Blood viscosity is then measured by using a parallel co-flowing method with a correction factor. The ESR is quantified as two indices (t_ESR, I_ESR) from image intensity of blood sample (<I_B>) over time. As a demonstration, the proposed method is employed to quantify contributions of hematocrit (Hct = 30%, 40%, and 50%), base solution (1× phosphate-buffered saline [PBS], plasma, and dextran solution), and hardened RBCs to blood viscosity and ESR, respectively. Experimental Results of the present method were comparable with those of the previous method. In conclusion, the proposed method has the ability to measure blood viscosity and ESR consistently, under fluid delivery of two ACSs.

Effect of shortening preoperative time of fasting and forbidding water on clinical outcome of elderly patients with gastrointestinal cancer

BACKGROUND

Prolonged fasting and water deprivation before surgery can easily lead to adverse reactions such as hunger, thirst, hypoglycemia, etc., especially in elderly patients. At present, most studies support shortening the duration of preoperative fasting and water, while domestic guidelines for preoperative fasting and water deprivation are for children, and there is no authoritative guide for adults.

AIM

To observe the effect of shortening preoperative time of fasting and forbidding water on the clinical outcome of elderly patients with gastrointestinal cancer.

METHODS

One hundred elderly patients with gastrointestinal cancer were divided into two groups (n = 50 each): experimental group and control group. The experimental group was fasted for 12 h and forbidden to drink water for 6 h before operation, and the control group was fasted for 6 h and forbidden to drink water for 2 h before operation. The changes of preoperative response, anesthesia effect, recovery time, hemodynamic index [mean arterial pressure (MAP), heart rate (HR)], and pulse oxygen saturation (SPO₂) before and 5 min after surgery were recorded. Postoperative rehabilitation effect was also recorded.

RESULTS

There were 6 (12%) cases in the experimental group and 29 (58%) in the control group. Preoperative reactions such as thirst, starvation, fatigue, and hope for eating occurred; the incidence between the two groups was statistically significant (χ² = 23.253, P < 0.001). The MAP, HR, and SPO₂ were significantly decreased in the experimental group and the control group at 5 min after operation (P < 0.05). The HR and SPO₂ at 5 min after operation in the experimental group were significantly higher than those in the control group (P > 0.05), although there was no significant difference in the MAP between the two groups (P < 0.05). There was no significant difference in the anesthesia effect between the two groups (P > 0.05), but there was a significant difference in the recovery time between them (t = -3.121, P = 0.002). There were significant differences in time to postoperative gastric tube removal, time to anal exhaust, time to body temperature recovery, and hospitalization days between the two groups (P < 0.05). There were no significant differences in postoperative nausea, postoperative vomiting, postoperative thirst, hunger, or postoperative pneumonia between the two groups (P > 0.05).

CONCLUSION

Reasonable arrangement of preoperative fasting time in elderly patients with gastrointestinal cancer may reduce the preoperative discomfort of patients and effectively improve the therapeutic effects, which is of great significance for the smooth performance of surgery and the promotion of postoperative rehabilitation.

A portable rotating disc as blood rheometer

Abnormalities in biophysical properties of blood are often strong indicators of life threatening infections. However, there is no existing device that integrates the sensing of blood hematocrit (or equivalently, packed cell volume), viscosity, and erythrocyte sedimentation rate (ESR) in a unified paradigm for point-of-care diagnostics. In an effort to develop a rapid, integrated, accurate, portable, and inexpensive sensing platform to diagnose the corresponding pathophysical parameters, we develop a simple and portable spinning disk capable of yielding these results in a few minutes instead of the traditional duration of hours. The device requires only 40 μl of unprocessed freshly drawn blood treated with an anticoagulant ethylenediaminetetraacetic acid, instead of the traditional requirement of 2 ml of blood for just the ESR measurement and still more for hematocrit determination. In contrast to the sophisticated instrumentation required to determine these parameters by the previously proposed microfluidic devices, our device requires minimal infrastructure. The measurement of hematocrit is accomplished by means of a simple 15 cm ruler. Additionally, a simple measurement of the blood flow rate enables the determination of the ESR value. The rapidity, ease, accuracy, portability, frugality, and possible automation of the overall measurement process of some of the most important parameters of blood under infection pinpoint its utility in extreme point-of-care settings.

Microfluidic-Based Biosensor for Sequential Measurement of Blood Pressure and RBC Aggregation Over Continuously Varying Blood Flows

Aggregation of red blood cells (RBCs) varies substantially depending on changes of several factors such as hematocrit, membrane deformability, and plasma proteins. Among these factors, hematocrit has a strong influence on the aggregation of RBCs. Thus, while measuring RBCs aggregation, it is necessary to monitor hematocrit or, additionally, the effect of hematocrit (i.e., blood viscosity or pressure). In this study, the sequential measurement method of pressure and RBC aggregation is proposed by quantifying blood flow (i.e., velocity and image intensity) through a microfluidic device, in which an air-compressed syringe (ACS) is used to control the sample injection. The microfluidic device used is composed of two channels (pressure channel (PC), and blood channel (BC)), an inlet, and an outlet. A single ACS (i.e., air suction = 0.4 mL, blood suction = 0.4 mL, and air compression = 0.3 mL) is employed to supply blood into the microfluidic channel. At an initial time (t < 10 s), the pressure index (PI) is evaluated by analyzing the intensity of microscopy images of blood samples collected inside PC. During blood delivery with ACS, shear rates of blood flows vary continuously over time. After a certain amount of time has elapsed (t > 30 s), two RBC aggregation indices (i.e., S_EAI: without information on shear rate, and erythrocyte aggregation index (EAI): with information on shear rate) are quantified by analyzing the image intensity and velocity field of blood flow in BC. According to experimental results, PI depends significantly on the characteristics of the blood samples (i.e., hematocrit or base solutions) and can be used effectively as an alternative to blood viscosity. In addition, S_EAI and EAI also depend significantly on the degree of RBC aggregation. In conclusion, on the basis of three indices (two RBC aggregation indices and pressure index), the proposed method is capable of measuring RBCs aggregation consistently using a microfluidic device.

Novel cone-and-plate flow chamber with controlled distribution of wall fluid shear stress

Fluid flow in blood vessels or interstitial fluid flow within tissue cavities plays important roles in tissue regeneration. One of the fundamental issues for in vitro study of the effects of fluid shear stress (FSS) on cells is the development of a flow chamber that can provide a controlled FSS field. In this study, we developed a novel cone-and-plate flow chamber based on viscometry technology, in which the cone's shape was optimized to produce a uniform wall FSS field on the surface of a standard six-well cell culture plate. By using a FSS finite element method, the effects of different geometric parameters of cone and plate, viscosity coefficient of fluid, and angular velocity on wall FSS at the bottom surface of the culture plate were investigated. Results of the simulation demonstrated that the cone with polyline or truncated generatrix (TG) could produce wall FSS as high as 1 or 2 Pa with uniform distribution, in which the area of the identical region for the cone with TG accounts for more than 69% of the total area. In addition, with the cone in close proximity to the plate surface, a gap distance of 0.1 mm can produce a uniform FSS field with a magnitude as high as 2 Pa over the majority of the plate. Furthermore, particle image velocimetry was utilized to measure the distribution of wall FSS, through which the numerical simulation results were experimentally demonstrated. This study presents a powerful new device for in vitro fluid flow loading at the cellular level.

Simultaneous measurement of blood pressure and RBC aggregation by monitoring on–off blood flows supplied from a disposable air-compressed pump

A simple method for simultaneously measuring RBC aggregation and blood pressure is demonstrated by analyzing blood flows supplied from a disposable air-compressed pump.

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.

Microfluidic-Based Technique for Measuring RBC Aggregation and Blood Viscosity in a Continuous and Simultaneous Fashion

Hemorheological properties such as viscosity, deformability, and aggregation have been employed to monitor or screen patients with cardiovascular diseases. To effectively evaluate blood circulating within an in vitro closed circuit, it is important to quantify its hemorheological properties consistently and accurately. A simple method for measuring red blood cell (RBC) aggregation and blood viscosity is proposed for analyzing blood flow in a microfluidic device, especially in a continuous and simultaneous fashion. To measure RBC aggregation, blood flows through three channels: the left wide channel, the narrow channel and the right wide channel sequentially. After quantifying the image intensity of RBCs aggregated in the left channel () and the RBCs disaggregated in the right channel (), the RBC aggregation index (AIPM) is obtained by dividing by . Simultaneously, based on a modified parallel flow method, blood viscosity is obtained by detecting the interface between two fluids in the right wide channel. RBC aggregation and blood viscosity were first evaluated under constant and pulsatile blood flows. AIPM varies significantly with respect to blood flow rate (for both its amplitude and period) and the concentration of the dextran solution used. According to our quantitative comparison between the proposed aggregation index (AIPM) and the conventional aggregation index (AICM), it is found that AIPM provides consistent results. Finally, the suggested method is employed to obtain the RBC aggregation and blood viscosity of blood circulating within an in vitro fluidic circuit. The experimental results lead to the conclusion that the proposed method can be successfully used to measure RBC aggregation and blood viscosity, especially in a continuous and simultaneous fashion.