Multiple and Periodic Measurement of RBC Aggregation and ESR in Parallel Microfluidic Channels under On-Off Blood Flow Control

The interaction between particles and vascular endothelium in blood flow

Particle-based drug delivery systems have shown promising application potential to treat human diseases; however, an incomplete understanding of their interactions with vascular endothelium in blood flow prevents their inclusion into mainstream clinical applications. The flow performance of nano/micro-sized particles in the blood are disturbed by many external/internal factors, including blood constituents, particle properties, and endothelium bioactivities, affecting the fate of particles in vivo and therapeutic effects for diseases. This review highlights how the blood constituents, hemodynamic environment and particle properties influence the interactions and particle activities in vivo. Moreover, we briefly summarized the structure and functions of endothelium and simulated devices for studying particle performance under blood flow conditions. Finally, based on particle-endothelium interactions, we propose future opportunities for novel therapeutic strategies and provide solutions to challenges in particle delivery systems for accelerating their clinical translation. This review helps provoke an increasing in-depth understanding of particle-endothelium interactions and inspires more strategies that may benefit the development of particle medicine.

Biomechanical Assessment of Red Blood Cells in Pulsatile Blood Flows

As rheological properties are substantially influenced by red blood cells (RBCs) and plasma, the separation of their individual contributions in blood is essential. The estimation of multiple rheological factors is a critical issue for effective early detection of diseases. In this study, three rheological properties (i.e., viscoelasticity, RBC aggregation, and blood junction pressure) are measured by analyzing the blood velocity and image intensity in a microfluidic device. Using a single syringe pump, the blood flow rate sets to a pulsatile flow pattern (Q_b[t] = 1 + 0.5 sin(2πt/240) mL/h). Based on the discrete fluidic circuit model, the analytical formula of the time constant (λ_b) as viscoelasticity is derived and obtained at specific time intervals by analyzing the pulsatile blood velocity. To obtain RBC aggregation by reducing blood velocity substantially, an air compliance unit (ACU) is used to connect polyethylene tubing (i.d. = 250 µm, length = 150 mm) to the blood channel in parallel. The RBC aggregation index (AI) is obtained by analyzing the microscopic image intensity. The blood junction pressure (β) is obtained by integrating the blood velocity within the ACU. As a demonstration, the present method is then applied to detect either RBC-aggregated blood with different concentrations of dextran solution or hardened blood with thermally shocked RBCs. Thus, it can be concluded that the present method has the ability to consistently detect differences in diluent or RBCs in terms of three rheological properties.

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.

Analysis of Polarization Images in the Microphysical Blood Parameters Research for the Hematocrit Diagnostics

The development of non-invasive optoelectronic technologies for human blood monitoring is one of the important research areas for medicine. A critical analysis of optoelectronic methods of blood research and the micromechanical systems based on them is carried out in this article. A design realization of a polarizing portable system for non-invasive monitoring of hematocrit as one of the basic homeostatic constants of the human body containing information about the microphysical parameters of blood cells has been substantiated. A physical model of polarized radiation conversion in a video information system of laser sensing of a biological research object has been formed. Visual and quantitative differences in the spatial distribution of polarization parameters of the scattered radiation for the states of the body with different hematocrit levels have been revealed. A scheme of a multichannel imaging portable system, based on a smartphone using miniature optical and microelectronic components of information conversion for non-invasive monitoring of microphysical blood parameters, has been created. The system implements the principle of polarimetric blood photometry and a multiparametric analysis of the polarization properties of the laser radiation scattered by blood. The developed portable optoelectronic system, based on a smartphone, can be used for rapid blood diagnostics in disaster medicine and the presence of clinical contraindications to the formation of invasive tests. The proposed polarization-based approach is a promising automated alternative to traditional devices and systems for the research of microphysical blood parameters.

Contributions of Red Blood Cell Sedimentation in a Driving Syringe to Blood Flow in Capillary Channels

The erythrocyte sedimentation rate (ESR), which has been commonly used to detect physiological and pathological diseases in clinical settings, has been quantified using an interface in a vertical tube. However, previous methods do not provide biophysical information on blood during the ESR test. Therefore, it is necessary to quantify the individual contributions in terms of viscosity and pressure. In this study, to quantify RBC sedimentation, the image intensity (Ib) and interface (β) were obtained by analyzing the blood flow in the microfluidic channels. Based on threshold image intensity, the corresponding interfaces of RBCs (Ib > 0.15) and diluent (Ib < 0.15) were employed to obtain the viscosities (µb, µ0) and junction pressures (Pb, P0). Two coefficients (CH1, CH2) obtained from the empirical formulas (µb = µ0 [1 + CH1], Pb = P0 [1 + CH2]) were calculated to quantify RBC sedimentation. The present method was then adopted to detect differences in RBC sedimentation for various suspended blood samples (healthy RBCs suspended in dextran solutions or plasma). Based on the experimental results, four parameters (µ0, P0, CH1, and CH2) are considered to be effective for quantifying the contributions of the hematocrit and diluent. Two coefficients exhibited more consistent trends than the conventional ESR method. In conclusion, the proposed method can effectively detect RBC sedimentation.

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.

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.

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.

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.

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.

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.

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.