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，而且往往是致命的恶化情况。严重并发症导致多器官功能障碍综合征或MODS，导致死亡率为41%。MODS病症的特征在于严重的急性炎症反应，导致血管血栓形成、败血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，以获得最佳的患者治疗。红细胞（RBC）聚集是炎症的一个强有力的标志物，并且具有通过超声成像提供连续监测能力的独特优势。这项资助 ** 提出了技术的开发和整合，以提供基于高频超声频谱数据分析的护理点患者 ** 监测，以测量在手臂或脚踝的浅静脉内流动的RBC的随时间变化的聚类。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连接到患者的手镯，并嵌入高频超声换能器，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，该数据由一个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 often**fatal deteriorating conditions. Severe complications leading to the syndrome of multiple organ**dysfunctions or MODS result in a mortality rate at 41%. The MODS condition is characterized**by a severe acute inflammatory reaction leading to vascular thrombosis, septic shock and**impaired oxygenation of organs and tissues. Inflammatory blood markers can be prescribed**for patient monitoring but results are obtained hours or days after sampling. In conditions**where rapid medical decisions are required to improve the likelihood of patient survival, those**blood tests are often of no value. We propose in this grant application a new bed side**ultrasound technology to continuously monitor the state of inflammation for optimum patient**treatment.**Red blood cell (RBC) aggregation is a strong marker of inflammation and has the unique**advantage of offering continuous monitoring capability through ultrasound imaging. This grant**proposes the development and integration of technologies to provide point-of-care patient**monitoring based on the analysis of high-frequency ultrasound spectral data to measure the**time-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 inflammationpromoted**aggregation of RBCs with ultrasound. The proposed algorithm is patented and we**propose the development of a portable instrument for use in restricted areas as surgery**rooms and intensive care units. This instrument will consist in a bracelet attached innocuously**to the patient and embedding high-frequency ultrasound transducers, an occluding device to**control the blood flow, and a positioning device to collect ultrasound data processed by a**miniaturized computer instrument to provide feedback to clinicians on the state of RBC**aggregation.