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可能会立即或延迟手术 心血管方面的妥协。在急性期，心功能通常通过肺功能监测 动脉导管和动脉导管。这有助于通过记录变化来预防心功能和心输出量的问题 从这些导管收集的信息中可以立即进行评估和治疗。然而， 这些设备，特别是肺动脉导管，对患者构成重大风险，包括致命的 心律失常、血管或心脏穿孔、呼吸道出血、缠绕和血栓 队形。如果病人病情严重，长时间或长时间留置导管是很常见的 定期调换。然而，留置管路有很高的血流感染和败血症风险。 此外，患者通常被卧床直到能够拔掉肺动脉导管。要添加 对此，该导管的心输出量测量往往是不可靠和不一致的。这可以使 能够适当地治疗病人是困难的和潜在的危险。我们提出这项建议的目的是 设计、制造和测试在心脏直视期间放置在主动脉和肺动脉表面的装置 手术可以提供心脏功能的信息，同时避免留置管路的风险。这个 设想的装置将：1)易于部署；2)通过在血管系统的表面上避免感染风险； 3)提供准确和精确的心功能测量；4)提供长期的术后解决方案 这是安全的，而且很容易拆卸。核心技术将是一种高度敏感的基于裂纹的应变传感器， 可被多路传输到阵列中，并与瞬时柔性粘性水凝胶集成。应变传感器 与粘性水凝胶集成将测量压力波形和流速；数据可用于 准确计算心输出量。传感器阵列将使用体外和体外模型进行测试，以校准 心输出量的测量。最后，我们将比较柔性应变传感器的活体测量结果。 与使用猪急性脑梗塞模型的肺动脉导管的结果相比较。的整体表现 暂态柔性粘贴式应变传感器阵列将以肺动脉导管为基准，现有 护理的标准。

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.