Design of a bracelet embedding high-frequency ultrasound transducers to acquire venous blood echogenicity spectral data for patient monitoring

每天，重症监护室的病人都在经历并发症，而且往往是致命的病情恶化。导致多器官功能障碍综合征或MODS的严重并发症导致41%的死亡率。MODS的特征是严重的急性炎症反应，导致血管血栓形成、感染性休克和器官和组织的氧合受损。炎症性血液标志物可用于患者监测，但结果是在采样后数小时或数天获得的。在需要快速医疗决策以提高患者生存可能性的情况下，这些血液检查通常没有价值。我们在这项拨款申请中提出了一种新的床旁超声技术，以持续监测炎症状态，为患者提供最佳治疗。红细胞（RBC）聚集是炎症的一个强有力标志物，具有通过超声成像提供持续监测能力的独特优势。该基金建议开发和整合技术，以提供基于高频超声频谱数据分析的即时患者监测，以测量在手臂或脚踝浅静脉内流动的红细胞随时间变化的聚集。猪模型的临床前结果证实了超声监测炎症促进红细胞聚集的能力。该算法已获得专利，我们建议开发一种便携式仪器，用于手术室和重症监护室等限制区域。该仪器将包括一个无害地附着在患者身上的手镯，其中嵌入了高频超声换能器，一个用于控制血流的闭塞装置，以及一个用于收集超声数据的定位装置，这些数据由微型计算机仪器处理，以向临床医生提供关于RBC聚集状态的反馈。

Every day, patients admitted to critical care units are experiencing complications and oftenfatal deteriorating conditions. Severe complications leading to the syndrome of multiple organdysfunctions or MODS result in a mortality rate at 41%. The MODS condition is characterizedby a severe acute inflammatory reaction leading to vascular thrombosis, septic shock andimpaired oxygenation of organs and tissues. Inflammatory blood markers can be prescribedfor patient monitoring but results are obtained hours or days after sampling. In conditionswhere rapid medical decisions are required to improve the likelihood of patient survival, thoseblood tests are often of no value. We propose in this grant application a new bed sideultrasound technology to continuously monitor the state of inflammation for optimum patienttreatment.Red blood cell (RBC) aggregation is a strong marker of inflammation and has the uniqueadvantage of offering continuous monitoring capability through ultrasound imaging. This grantproposes the development and integration of technologies to provide point-of-care patientmonitoring based on the analysis of high-frequency ultrasound spectral data to measure thetime-varying clustering of RBCs flowing within a superficial vein of the arm or ankle.Preclinical results in a porcine model confirmed the capability of monitoring inflammationpromotedaggregation of RBCs with ultrasound. The proposed algorithm is patented and wepropose the development of a portable instrument for use in restricted areas as surgeryrooms and intensive care units. This instrument will consist in a bracelet attached innocuouslyto the patient and embedding high-frequency ultrasound transducers, an occluding device tocontrol the blood flow, and a positioning device to collect ultrasound data processed by aminiaturized computer instrument to provide feedback to clinicians on the state of RBCaggregation.