Multiplexed device for rapid coagulopathy testing

用于快速凝血病检测的多重装置

• 批准号: 10285382
• 负责人: Charles Corey Hardin
• 金额: $ 46.2万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2023-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10285382
• 关键词: Address; Adult Respiratory Distress Syndrome; Aerosols; Antithrombins; Autopsy; Biological Assay; Biomimetics; Blood; Blood Chemical Analysis; Blood Coagulation Disorders; Blood Coagulation Factor; Blood Platelets; Blood Tests; Blood Vessels; Blood coagulation; Blood coagulation tests; Blood flow; Blood specimen; COVID-19; COVID-19 patient; COVID-19 testing; Case Study; Cessation of life; Characteristics; China; Clinic; Clinical; Clinical assessments; Coagulation Process; Collagen; Complement; Critical Illness; Data; Deposition; Device Designs; Devices; Diagnosis; Dimensions; Disseminated Intravascular Coagulation; Drops; Elements; Etiology; Event; Exhibits; Exposure to; Fibrin; Fibrin fragment D; Fibrinogen; Gel; Geometry; Hemorrhage; Hemostatic function; Hour; Incidence; Inflammation; International Normalized Ratio; Ischemic Bowel Disease; Italy; Life; Lung; Measurement; Measures; Medical; Methods; Microfluidic Microchips; Molds; Myocardial Infarction; Pathway interactions; Patient Care; Patients; Performance; Phenotype; Procedures; Process; Prothrombin time assay; Province; Pulmonary Embolism; Reporting; Resistance; Respiration Disorders; Respiratory Failure; Risk; Role; Sepsis; Stroke; Structure of parenchyma of lung; Surface; Survivors; System; Technology; Testing; Thinness; Thrombelastography; Thrombophilia; Thromboplastin; Thrombosis; Time; Trauma; Travel; Vacuum; Viscosity; Whole Blood; clinical application; clinical practice; cytokine; design; epidemiologic data; experience; experimental study; global health; improved; in vivo; limb ischemia; microfluidic technology; mortality; new technology; point of care testing; pressure; rapid diagnosis; risk minimization; thrombotic; thrombotic complications; tool; venous thromboembolism; ventilation; web site

Abstract COVID-19 has emerged as a global health challenge, with more than 37 million cases reported and 1,079,029 deaths (as of October 13, 2020 according to the WHO website). Although the precise etiology of coagulopathies in COVID-19 is not clear, damage to lung tissue, increased cytokine levels and alteration of blood chemistry due to inflammation and sepsis all likely contribute. The resulting inappropriate hemostasis (the process of making blood clots to stop bleeding) is a major challenge in the care of these patients. Importantly, the coagulation profile of a COVID-19 patient – and consequently the appropriate medical treatment – might change from hour to hour. Because asymptomatic patients can develop life-threatening coagulopathy-related thrombotic events, robust, frequent and inexpensive tests for blood coagulation aberrations would help identify at-risk patients. Current methods for clinical assessment of coagulation status are cumbersome, expensive and limited in scope, and clinicians are frustrated by the lack of robust tools to address coagulopathy in COVID-19. Leveraging our expertise in blood coagulopathy, COVID-19 management and microfluidics technology, we propose to develop and test technology for improving diagnosis of blood coagulation status in COVID-19-positive patients. The technology is simple, but multiplexed, replacing multiple blood tests currently used in the clinic. Because the blood sample is always contained within the device, risk of exposure to infected blood is minimized. It uses biomimetic principles to challenge blood to flow through vascular-like channels that are pre-treated with specific coagulation factors. We will optimize the design of the device and validate its performance against existing assay methods. When complete, this project will provide new technology for rapid, repeated point of care testing of blood coagulopathy in COVID-19 and other diverse clinical applications.

抽象的 Covid-19已成为全球健康挑战，报告了超过3700万例案件和1,079,029例 死亡（截至2020年10月13日，根据WHO网站）。虽然凝血病的精确病因 在Covid-19中不清楚，对肺组织的损害，细胞因子水平升高以及血液化学的改变 炎症和败血症都可能有贡献。导致适当的止血（制作过程 停止出血的血液凝块是照顾这些患者的主要挑战。重要的是，凝血 COVID-19患者的概况 - 因此，适当的医疗可能会从小时变化 到一个小时。由于不对称患者可以发展威胁生命的凝血病有关的血栓性血小板事件，所以 对血液凝结畸变的稳健，经常且廉价的测试将有助于识别高危患者。 当前用于凝血状态临床评估的方法很麻烦，昂贵且范围有限， 临床医生因缺乏解决Covid-19的凝血病的强大工具而感到沮丧。利用我们的 血液凝血病，COVID-19管理和微流体技术方面的专业知识，我们建议开发 和测试技术，用于改善COVID-19阳性患者的血液凝结状态诊断。 技术很简单，但多路复用，取代了诊所当前使用的多个血液检查。因为 血液样本始终包含在设备中，暴露于感染血液的风险被最小化。它使用 挑战血液流经血管状通道的仿生原理 凝血因子。我们将优化设备的设计，并针对现有测定验证其性能 方法。完成后，该项目将为快速，重复的护理点测试提供新技术 Covid-19和其他多种临床应用中的血液凝血病。

项目成果

Planning for the Next Pandemic: Trauma Injuries Require Pre-COVID-19 Levels of High-Intensity Resources.

规划下一次大流行：创伤需要 COVID-19 之前水平的高强度资源。

• DOI: 10.1177/00031348221087414
• 发表时间: 2022
• 期刊: The American surgeon
• 作者: Mokhtari,AvaK;Maurer,LydiaR;Wong,YeeM;Hardman,Claire;Hafiz,Shabnam;Sharrah,Mark;Soe-Lin,Hahn;Peralta,Rafael;Parks,JonathanJ;Rattan,Rishi;Butler,Caroline;Hwabejire,JohnO;Fawley,Jason;Fagenholz,PeterJ;King,DavidR;Kaafara
• 通讯作者: Kaafara

Adding to the story, did penetrating trauma really increase? changes in trauma patterns during the COVID-19 pandemic: A multi-institutional, multi-region investigation.

• DOI: 10.1016/j.injury.2022.02.034
• 发表时间: 2022-06
• 期刊: Injury
• 影响因子: 2.5
• 作者: Mokhtari AK;Maurer LR;Dezube M;Langeveld K;Wong YM;Hardman C;Hafiz S;Sharrah M;Soe-Lin H;Chapple KM;Peralta R;Rattan R;Butler C;Parks JJ;Mendoza AE;Velmahos GC;Saillant NN
• 通讯作者: Saillant NN

Strategies to minimize heterogeneity and optimize clinical trials in Acute Respiratory Distress Syndrome (ARDS): Insights from mathematical modelling.

• DOI: 10.1016/j.ebiom.2021.103809
• 发表时间: 2022-01
• 期刊: EBioMedicine
• 影响因子: 11.1
• 作者: Subudhi S;Voutouri C;Hardin CC;Nikmaneshi MR;Patel AB;Verma A;Khandekar MJ;Dutta S;Stylianopoulos T;Jain RK;Munn LL
• 通讯作者: Munn LL