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

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.

Sensing of Fluidic Features Using Colloidal Microswarms

Sensing of key parameters in fluidic environments has attracted extensive attention because the physical features of body fluids could be used for point-of-care disease diagnosis. Although various sensing methods have been investigated, effective sensing strategies of microenvironments remains a major challenge. In this paper, we propose an approach that can realize sensing of fluidic viscosity and ionic strength using microswarms formed by simple colloidal nanoparticles. The influences of fluidic ionic strength and viscosity on two swarm behaviors are analyzed (i.e., the spreading of circular vortex-like swarms and the elongation of elliptical swarms). The data models for quantifying the fluidic viscosity and ionic strength are obtained from experiments, and the fluidic features can be sensed successfully using the swarm behaviors. Furthermore, we demonstrate that the microswarms have the capability of passing through tortuous and narrow microchannels for sensing. Continuous sensing of different fluidic environments using swarms is also realized. Finally, the sensing of viscosity and ionic strength of porcine whole blood is presented, which also validates the feasibility of the sensing strategy.

Persistent red blood cells retain their ability to move in microcapillaries under high levels of oxidative stress

Oxidative stress is one of the key factors that leads to red blood cells (RBCs) aging, and impairs their biomechanics and oxygen delivery. It occurs during numerous pathological processes and causes anaemia, one of the most frequent side effects of cancer chemotherapy. Here, we used microfluidics to simulate the microcirculation of RBCs under oxidative stress induced by tert-Butyl hydroperoxide. Oxidative stress was expected to make RBCs more rigid, which would lead to decrease their transit velocity in microfluidic channels. However, single-cell tracking combined with cytological and AFM studies reveals cell heterogeneity, which increases with the level of oxidative stress. The data indicates that the built-in antioxidant defence system has a limit exceeding which haemoglobin oxidation, membrane, and cytoskeleton transformation occurs. It leads to cell swelling, increased stiffness and adhesion, resulting in a decrease in the transit velocity in microcapillaries. However, even at high levels of oxidative stress, there are persistent cells in the population with an undisturbed biophysical phenotype that retain the ability to move in microcapillaries. Developed microfluidic analysis can be used to determine RBCs' antioxidant capacity for the minimization of anaemia during cancer chemotherapy.

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.

Microfluidics Approach to the Mechanical Properties of Red Blood Cell Membrane and Their Effect on Blood Rheology

In this article, we describe the general features of red blood cell membranes and their effect on blood flow and blood rheology. We first present a basic description of membranes and move forward to red blood cell membranes’ characteristics and modeling. We later review the specific properties of red blood cells, presenting recent numerical and experimental microfluidics studies that elucidate the effect of the elastic properties of the red blood cell membrane on blood flow and hemorheology. Finally, we describe specific hemorheological pathologies directly related to the mechanical properties of red blood cells and their effect on microcirculation, reviewing microfluidic applications for the diagnosis and treatment of these diseases.

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.

Optical coherence viscometry

We report a technique, named optical coherence viscometry (OCV), to measure the viscosity of Newtonian fluids in a noncontact manner. According to linear wave theory with small amplitudes, capillary waves are associated with fluid mechanical properties. To perform this measurement and avoid the overdamped effects of capillary waves in viscous fluids, transient acoustic radiation force was applied to generate capillary waves. Within a very limited field-of-view using optical coherence tomography, wave motion acquired in the time domain was analyzed using Fourier methods to study the wave velocity dispersion and attenuation relationships for capillary waves, which can reduce the fluid quantity drastically into tissue culture scale. We measure the viscosities of water, water-glycerol solutions with three concentrations, and biological plasma using the proposed OCV and compare the experimental results to theoretical calculations. OCV is sensitive to wave perturbations and can be a promising technique for measuring the viscosity of biological fluids and could be applied in future applications for measurements for lipid membranes in cell biology and tissue engineering investigation.

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.

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.

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.