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.

摘要 COVID-19已成为全球健康挑战，报告病例超过3700万例， 死亡人数（根据世卫组织网站，截至2020年10月13日）。虽然凝血功能障碍的确切病因 在COVID-19中尚不清楚，肺组织的损伤，细胞因子水平的增加和血液化学的改变， 炎症和脓毒症都有可能由此产生的不适当止血（制作过程 血凝块以止血）是护理这些患者的主要挑战。重要的是， COVID-19患者的情况-以及相应的适当医疗-可能会随着时间的推移而变化 到小时由于无症状患者可发生危及生命的凝血病相关血栓事件， 对血液凝固异常进行可靠、频繁和廉价的测试将有助于识别有风险的患者。 目前用于临床评估凝血状态的方法繁琐、昂贵且范围有限， 临床医生对缺乏强大的工具来解决COVID-19中的凝血障碍感到沮丧。利用我们 在血液凝固病，COVID-19管理和微流体技术方面的专业知识，我们建议开发 以及用于改善COVID-19阳性患者凝血状态诊断的检测技术。的 该技术简单，但多路复用，取代了目前临床上使用的多种血液检测。因为 血液样本始终包含在设备内，暴露于受感染血液的风险最小化。它使用 仿生原理挑战血液流过血管样通道， 凝血因子我们将优化设备的设计，并验证其性能对现有的测定 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和其他不同临床应用中的凝血病。

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