VF Doppler Smart Sensor for Dialysis and Vascular Applications

描述（由申请人提供）：本申请涉及广泛的挑战领域15：转化科学和具体的挑战主题15- rr -101：应用转化技术开发。很明显，在透析通路失败（血栓形成）之前，每个透析患者的通路流量在一段时间内从基线值减少到零。然而，通路故障的自然历史和变化仍然知之甚少，正如临床实施通路流量监测时的混合结果所证明的那样。已知的是，在许多临床环境中，习惯的每月访问流量监测不够频繁。由于通道监测的有效性取决于进行监测的频率，因此需要一种易于使用且准确的测量通道流量的方法来了解流量变化并确定如何最佳地监测具有不同特征的患者。在这个项目中开发和测试的新仪器是基于成熟的多普勒技术，降低了开发风险，但将采用一种新的测量方法，技术先进的电子和软件，使一个用户友好的，低成本的多普勒为透析通道监测量身定制的监测设备。这种智能传感器将在每个患者的每次透析治疗过程中实现经济高效、准确的流量监测，这对于优化该临床应用的综合灵敏度和特异性至关重要。该提案的结果将1)改善透析决策，导致优化通路监测的范式转变，2)为其他血管应用提供多普勒设备平台。此外，该项目实际上将降低透析血管通路成本。现实的估计表明，仅在美国每年就可节省3亿美元，同时刺激技术医疗保健部门的就业机会。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area 15: Translational Science and specific Challenge Topic 15-RR-101: Applied Translational Technology Development. It is evident that prior to dialysis access failure (thrombosis), access flow decreases for every dialysis patient from a baseline value to zero over some time period. However, the natural history and variation of access failure is still poorly understood, as evidenced by mixed results when access flow monitoring is implemented clinically. What is known is that customary monthly access flow monitoring is not frequent enough in many clinical settings. Since the effectiveness of access surveillance depends on the frequency with which monitoring can be performed, an easy-to-use and accurate method of measuring access flow is needed to understand flow variation and to determine how to optimally monitor patients with differing characteristics. The new instrument being developed and tested in this project is based on mature Doppler technology mitigating development risk, yet will employ a novel measurement method, technologically advanced electronics and software to make a user-friendly, low-cost Doppler- based monitoring device tailored for dialysis access monitoring. This smart sensor will allow cost-effective, accurate flow monitoring during each dialysis treatment for every patient, which is essential to optimize combined sensitivity and specificity for this clinical application. The results of this proposal will 1) improve dialysis decision-making leading to a paradigm shift to optimize access monitoring and 2) provide a platform Doppler device for other vascular applications. Further, this project will actually reduce dialysis vascular access cost. Realistic estimates indicate $300 million in annual savings in the US alone, while stimulating jobs in the technical healthcare sector. PUBLIC HEALTH RELEVANCE: It is important to fund technologies that will make US workers more competitive in the global marketplace by reducing overall healthcare costs. This project achieves the scientific and economic objectives of the ARRA. This project will result in a low-cost compact Doppler based smart sensor for dialysis vascular access management. This device and technology will reduce dialysis healthcare cost and are easily generalizable to other vascular applications, offering a high-performance alternative to existing Doppler devices. The project supports rapid translation into the private sector and job creation achieving scientific and economic stimulus objectives of the ARRA.