Blood Coagulation Monitoring at the Point of Care

描述：该项目的目标是开发和验证一种手持式传感器，用于快速和全面评估患者的凝血状态。凝血功能受损或凝血功能障碍，由与严重创伤、手术或疾病相关的几种情况引起，并可导致危及生命的出血或血栓性疾病。凝血不足可导致“低凝”状态，导致无法控制的出血，这可能导致严重的贫血、休克和多器官衰竭。在其他情况下，凝血缺陷可能表现为“高凝”状态，导致凝血增加，可能导致潜在的致命并发症，如深静脉血栓形成和肺栓塞。在手术、创伤护理和慢性疾病管理中，临床医生经常遇到维持出血和凝血之间不稳定平衡的挑战性任务。因此，为了达到最佳效果，在治疗过程中早期发现凝血缺陷和凝血监测是必不可少的。不幸的是，由于标准实验室检查的周转时间长，目前对凝血功能受损的诊断和治疗监测存在问题。我们的提案直接解决了未满足的临床需求，即开发和翻译一种手持式便携式凝血传感器，称为光学血栓弹性成像（OTEG），用于护理点使用。这项技术包括在一个小药筒里滴几滴血。激光光源照射血液样本，CMOS相机拍摄样本随时间反射的激光散斑图案。通过实时分析激光散斑强度波动，我们可以测量血液在凝血过程中的粘弹性特性，并恢复多个凝血指标的信息。OTEG设备还将提供实时测量血小板聚集的能力，以诊断患者血小板功能受损。因此，

DESCRIPTION: The goal of this project is to develop and validate a hand-held sensor for the rapid and comprehensive assessment of coagulation status in patients. Impaired blood coagulation or coagulopathy, results from several conditions associated with severe trauma, surgery or illness, and can cause life-threatening bleeding or thrombotic disorders. Deficient coagulation can lead to 'hypocoagulable' states resulting in uncontrolled bleeding, which may cause severe anemia, shock and multiple organ failure. In other cases, coagulation defects may manifest as 'hypercoagulable' states, causing increased clotting that can result in potentially fatal complications such as deep vein thrombosis and pulmonary embolism. During surgery, trauma care and chronic disease management, clinicians often encounter the challenging task of maintaining a precarious balance between bleeding and coagulation. In order to achieve optimal outcome, the early detection of coagulation defects and coagulation monitoring during therapy is therefore essential. Unfortunately, the diagnosis and treatment monitoring of impaired coagulation is currently problematic because of the long turn-around time of standard laboratory tests. Our proposal directly addresses the unmet clinical need to develop and translate a hand-held, portable coagulation sensor, termed Optical Thromboelastography (OTEG) for point of care use. The technique involves placing a few drops of blood in a small cartridge. A laser source illuminates the blood sample and a CMOS camera images laser speckle patterns reflected from the sample over time. By analyzing laser speckle intensity fluctuations in real-time, we can measure blood viscoelastic properties during coagulation and recover information about multiple coagulation metrics. The OTEG device will also provide the capability to measure platelet aggregation in real- time to diagnose impaired platelet function in patients. As a result, using a single portable device with a few drops of blood, OTEG can achieve the comprehensive assessment of multiple parameters: clotting time, clot viscoelasticity and formation rate, fibrinogen, fibrinolysis and platelet function, within a few minutes. To validate the device, we wil perform studies to test the accuracy of OTEG via comparison with standard thromboelastography and laboratory tests. In the final phase of our work, we will conduct a clinical study to evaluate the utility of OTEG for coagulation monitoring in patients at the point f care.