Adhesive Transient Strain Sensors for Monitoring Post-Cardiotomy Hemodynamics

摘要 多达20%的接受心脏直视手术的患者术后可立即或延迟发生心脏病。 心血管损害在即刻阶段，通常使用肺动脉导管监测心脏功能。 动脉导管和动脉线。这有助于防止问题的心功能和输出量的注意变化 从这些导管收集的信息中，可以立即进行评估和治疗。然而，在这方面， 这些装置，特别是肺动脉导管，对患者存在显著的风险， 心律失常、血管或心脏穿孔、气道出血、缠绕和血栓 阵如果病人病得很重，很常见的是将该导管长时间保持在原位，或者 定期交换。然而，留置管线具有血液感染和败血症的高风险。 此外，患者通常保持在床上，直到能够移除肺动脉导管。添加 对此，来自该导管的心输出量的测量通常是不可靠和不一致的。这可以使 能够对患者进行适当的治疗很困难，并且存在潜在的危险。我们提出这项建议的目的是 设计、制造和测试在心脏直视手术期间放置在主动脉和肺动脉表面的装置 可以提供心脏功能信息的手术，同时避免留置导管的风险。的 所设想的装置将：1）容易展开; 2）通过在脉管系统的表面上避免感染的风险; 3)提供准确和精确的心脏功能测量; 4）提供长期的术后解决方案 它是安全的，而且很容易拆卸。核心技术将是一种高灵敏度的基于裂纹的应变传感器， 可以多路复用成阵列并与瞬时柔性粘合剂水凝胶集成。应变传感器 与粘合剂水凝胶集成将测量压力波形和流速;可用于 准确计算心输出量。传感器阵列将使用体外和离体模型进行测试，以校准 测量心输出量。最后，我们将比较柔性应变传感器的体内测量 与肺动脉导管使用猪急性梗塞模型的结果相同。的整体性能 瞬态柔性粘合应变传感器阵列将以肺动脉导管为基准，现有的 护理标准。

ABSTRACT As many as 20% of patients undergoing open heart surgery can have immediate or delayed postoperative cardiovascular compromise. In the immediate period, cardiac function is often monitored using a pulmonary artery catheter and an arterial line. This helps prevent problems in cardiac function and output by noting changes from the information gathered from these catheters that allow immediate assessment and treatment. However, these devices, particularly the pulmonary artery catheter, present significant risks to patients including fatal arrhythmias, perforation of blood vessels or the heart, bleeding into the airway, entanglement and thrombus formation. If the patient is very sick, it is very common to keep this catheter in place for a prolonged period or exchange it on a regular basis. However, indwelling lines carry a high risk of bloodstream infection and sepsis. Furthermore, patients typically are kept in bed until the pulmonary artery catheter is able to be removed. To add to this, the measurement of cardiac output from this catheter is often unreliable and inconsistent. This can make being able to treat the patient appropriately difficult and potentially dangerous. Our goal of this proposal is to design, fabricate, and test a device placed on the surface of the aorta and pulmonary artery during open heart surgery that can provide information on cardiac function, while avoiding the risk of indwelling lines. The envisioned device will: 1) be easily deployed; 2) avoid risk of infection by being on the surface of the vasculature; 3) provide accurate and precise measurements of cardiac function; 4) provide a long-term postoperative solution that is safe and easily removable. The core technology will be a highly sensitive crack-based strain sensor that can be multiplexed into arrays and integrated with transient flexible adhesive hydrogels. Strain sensors integrated with adhesive hydrogels will measure pressure waveforms and flow rates; data that can be used to accurately calculate cardiac output. Sensor arrays will be tested using in vitro and ex vivo models to calibrate measurements with cardiac output. Finally, we will compare the in vivo measurements of flexible strain sensors with that of pulmonary artery catheters using an acute infarct model in swine. The overall performance of transient flexible adhesive strain sensor arrays will be benchmarked to pulmonary artery catheters, the existing standard of care.