Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany.
Biosensors (Basel). 2023 Mar 17;13(3):394. doi: 10.3390/bios13030394.
Clot formation inside a membrane oxygenator (MO) due to blood-to-foreign surface interaction represents a frequent complication during extracorporeal membrane oxygenation. Since current standard monitoring methods of coagulation status inside the MO fail to detect clot formation at an early stage, reliable sensors for early clot detection are in demand to reduce associated complications and adverse events. Bioimpedance analysis offers a monitoring concept by integrating sensor fibers into the MO. Herein, the feasibility of clot detection via bioimpedance analysis is evaluated. A custom-made test chamber with integrated titanium fibers acting as sensors was perfused with heparinized human whole blood in an in vitro test circuit until clot formation occurred. The clot detection capability of bioimpedance analysis was directly compared to the pressure difference across the test chamber (ΔP-TC), analogous to the measurement across MOs (ΔP-MO), the clinical gold standard for clot detection. We found that bioimpedance measurement increased significantly 8 min prior to a significant increase in ΔP-TC, indicating fulminant clot formation. Experiments without clot formation resulted in a lack of increase in bioimpedance or ΔP-TC. This study shows that clot detection via bioimpedance analysis under flow conditions in a blood-perfused test chamber is generally feasible, thus paving the way for further investigation.
由于血液与外来表面相互作用导致膜式氧合器（MO）内形成血栓，这是体外膜氧合过程中常见的并发症。由于目前 MO 内凝血状态的常规监测方法无法早期检测到血栓形成，因此需要可靠的传感器来早期检测血栓，以减少相关并发症和不良事件。生物阻抗分析通过将传感器纤维集成到 MO 中提供了一种监测概念。本文评估了通过生物阻抗分析检测血栓形成的可行性。在体外测试回路中，用肝素化的人全血灌注具有集成钛纤维的定制测试室，直到发生血栓形成。生物阻抗分析的血栓检测能力与测试室两端的压差（ΔP-TC）直接进行比较，类似于 MO 两端的压差（ΔP-MO），这是血栓检测的临床金标准。我们发现，生物阻抗测量在 ΔP-TC 显著增加之前 8 分钟就显著增加，表明血栓迅速形成。没有血栓形成的实验导致生物阻抗或 ΔP-TC 没有增加。本研究表明，在血流灌注的测试室内，通过生物阻抗分析在流动条件下检测血栓通常是可行的，从而为进一步的研究铺平了道路。
