Flexible bioelectronic sensors for non-contact detection of obstruction in pediatric vascular shunts

有一个或两个脑室缺陷的新生儿患者依赖于改良的Blalock-Taussig 分流(MBTS)以建立适当的全身血流量。虽然这个手术挽救了许多新生儿的生命 青紫型心脏缺陷，血栓和/或内膜积聚所致的MBTS梗阻 导致高死亡率和高发病率的问题。此外，护理费用也是最高的 对于任何外科手术来说都很昂贵。 分流阻塞可因肺循环不足而导致缺氧和猝死。 分流阻塞可以是突然的，并且没有足够的警告来防止患者的病情迅速恶化 条件。或者，分流阻塞也可以逐渐发生。但即使是在这种情况下，缩小范围 分流管腔的关闭可能会导致类似的不良副作用。当需要紧急干预时， 尽管进行了非常积极的复苏，但往往很难挽救患有分流梗阻的婴儿。 再通可以纠正分流梗阻。影像方法不足以解决梗阻 在这些直径3-5 mm的分流管内。因此，及早发现分流梗阻是避免 需要紧急干预和可预防的生命损失。 这项建议解决了临床上尚未满足的对微型传感器的需求，这种传感器可以检测到显著的 通过MBTS的血流变化需要干预。开发适合使用的流量传感器 分流手术带来了几个独特的挑战，但如果成功，可以通过 及时、知情的再融资。 系统方法包括首先在非接触式平台上演示概念验证 流量传感，然后开发适合活体使用的分流传感器系统，然后是最终的 在猪模型中演示有线传感器。这项工作的预期结果是演示 适用于分流装置的非接触式流量传感器，使传感器分流系统成为MBTS。这个 成功的演示将为无线遥测的开发铺平道路，使无线 用于慢性动物研究的MBTS。该非接触式传感方法也可应用于其他非接触式传感器 血管移植或引流分流术。该提案将建立对实现以下目标至关重要的概念验证 家庭护理中用于定期监测的无线探头流量传感器系统的长期目标 启用早期预警的设置，以推动拯救生命的干预。

Neonatal patients having one or two ventricle defects are dependent on the modified Blalock-Taussig shunt (mBTS) to establish proper systemic blood flow. While the procedure has saved many newborns with cyanotic heart defects, the obstruction of mBTS due to either thrombus and/or intimal build up has been problematic leading to high mortality and morbidity. In addition, the cost of care is among the most expensive for any surgical procedure. Shunt obstruction can lead to hypoxia and sudden death due to insufficient pulmonary circulation. Shunt occlusion can be sudden and without enough warning to prevent rapid deterioration of the patient’s condition. Alternatively, shunt obstruction can also occur gradually. But even in this case, the narrowing of the shunt lumen may result in similar adverse side effects. When emergency intervention is required, despite very aggressive resuscitation, it is frequently difficult to save infants with shunt obstruction. Recanalization can correct shunt obstruction. Imaging methods are inadequate to resolve obstruction within these 3-5 mm diameter shunts. Therefore, early detection of shunt obstruction is critical to avoid the need for emergency intervention and preventable loss of life. This proposal addresses the unmet clinical need for miniature sensors that can detect significant changes in blood flow through mBTS necessitating intervention. Developing flow sensors suitable for use with shunts poses several unique challenges but if successful, can reduce morbidity and mortality through timely, informed recanalization. The systematic approach involves first demonstrating proof-of-concept at the benchtop of non-contact flow sensing, followed by developing shunt sensor systems suitable for in vivo use, and then a final demonstration of wired sensors in a pig model. The expected outcome of this work is the demonstration of a non-contact flow sensor suitable for use with shunts to enable a sensor-shunt system as mBTS. The successful demonstration will pave the way for development of a wireless telemetry to enable a wireless mBTS for chronic animal studies. The non-contact sensing method also can be applied to other synthetic vascular grafts or drainage shunts. This proposal will establish proof-of-concept that is critical to achieve the long term goal of a wirelessly interrogated flow sensor system for periodic monitoring in a home care setting that enables early warning to drive intervention that saves lives.