Adhesive Transient Strain Sensors for Monitoring Post-Cardiotomy Hemodynamics

用于监测心脏切开术后血流动力学的粘附式瞬态应变传感器

• 批准号: 10057306
• 负责人: Michael Scott Halbreiner
• 金额: $ 22.17万
• 依托单位: ALLEGHENY-SINGER RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057306
• 关键词: 3-Dimensional; Acute; Adhesives; Anemia; Aorta; Arrhythmia; Arterial Lines; Beds; Benchmarking; Blood Pressure; Blood Vessels; Blood flow; Cardiac; Cardiac Output; Cardiac Surgery procedures; Cardiovascular system; Catheters; Clinical; Clinical assessments; Complication; Critical Illness; Dangerousness; Data; Device Designs; Devices; Disease; Dopamine; Electrodes; Event; Family suidae; Goals; Heart; Heart Injuries; Hemorrhage; Hydrogels; In Vitro; Incidence; Infarction; Infection; Lead; Measurement; Measures; Medical; Microfabrication; Modeling; Monitor; Morbidity - disease rate; Nature; Operative Surgical Procedures; Patients; Perforation; Performance; Perfusion; Perioperative; Postoperative Period; Pulmonary artery structure; Risk; Rupture; Saint Jude Children' s Research Hospital; Sepsis; Shock; Side; Structure; Surface; System; Techniques; Technology; Testing; Thrombus; Time; Tissues; Tricuspid Valve Insufficiency; United States; base; biomaterial compatibility; cardiovascular risk factor; catheter related infection; design; flexibility; heart function; hemodynamics; high risk; implantable device; improved; in vivo; infection risk; migration; mortality; novel; pressure; prevent; sensor; standard of care; voltage

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.

抽象的 多达20％的接受开放式心脏手术的患者可以立即或延迟术后 心血管妥协。在不久的是，通常使用肺部来监测心脏功能 动脉导管和动脉线。这有助于通过注意变化来防止心脏功能和输出问题 从这些导管收集的信息中，可以立即进行评估和治疗。然而， 这些装置，尤其是肺动脉导管 心律不齐，血管或心脏的穿孔，流向气道，纠缠和血栓 形成。如果病人病得很重，很常见将该导管延长一段时间或 定期换它。但是，留置线具有血流感染和败血症的高风险。 此外，通常将患者躺在床上，直到能够去除肺动脉导管为止。添加 为此，该导管的心输出量通常不可靠且不一致。这可以做到 能够治疗患者适当困难且潜在的危险。我们的这一建议的目标是 开放式心脏期间，设计，制造和测试放置在主动脉和肺动脉表面上的设备 可以提供有关心脏功能的信息的手术，同时避免了留置线的风险。这 设想的设备将：1）轻松部署； 2）避免在脉管系统的表面避免感染风险； 3）提供心脏功能的准确和精确的测量； 4）提供长期术后解决方案 这是安全易于移动的。核心技术将是一个高度敏感的基于裂纹的应变传感器 可以将多路复用到阵列中，并与瞬态柔性粘合水凝胶集成。应变传感器 与粘合水凝胶整合在一起将测量压力波形和流速；可以用来习惯的数据 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 心输出量的测量。最后，我们将比较柔性应变传感器的体内测量 使用猪中急性梗塞模型的肺动脉导管的使用。总体表现 瞬态柔性粘合应变传感器阵列将基准为肺动脉导管，现有 护理标准。