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基于模型的快速预测血液蛋白浓度下的粘弹性血凝块强度,用于 cybermedical 凝血控制。

Quick model-based viscoelastic clot strength predictions from blood protein concentrations for cybermedical coagulation control.

机构信息

Department of Mechanical and Aerospace Engineering, University of Florida, 527 Gale Lemerand Drive, Gainesville, FL, 32611-6250, USA.

ASML, 17075 Thornmint Court, San Diego, CA, 92127-2413, USA.

出版信息

Nat Commun. 2024 Jan 5;15(1):314. doi: 10.1038/s41467-023-44231-w.

Abstract

Cybermedical systems that regulate patient clotting in real time with personalized blood product delivery will improve treatment outcomes. These systems will harness popular viscoelastic assays of clot strength such as thromboelastography (TEG), which help evaluate coagulation status in numerous conditions: major surgery (e.g., heart, vascular, hip fracture, and trauma); liver cirrhosis and transplants; COVID-19; ICU stays; sepsis; obstetrics; diabetes; and coagulopathies like hemophilia. But these measurements are time-consuming, and thus impractical for urgent care and automated coagulation control. Because protein concentrations in a blood sample can be measured in about five minutes, we develop personalized, phenomenological, quick, control-oriented models that predict TEG curve outputs from input blood protein concentrations, to facilitate treatment decisions based on TEG curves. Here, we accurately predict, experimentally validate, and mechanistically justify curves and parameters for common TEG assays (Functional Fibrinogen, Citrated Native, Platelet Mapping, and Rapid TEG), and verify results with trauma patient clotting data.

摘要

实时调节患者凝血功能并个性化输送血液制品的网络医疗系统将改善治疗效果。这些系统将利用血栓弹力描记法(TEG)等流行的粘弹性凝块强度检测,以帮助评估多种情况下的凝血状态:大手术(如心脏、血管、髋部骨折和创伤);肝硬化和移植;COVID-19;重症监护病房;败血症;产科;糖尿病;以及血友病等凝血障碍。但这些测量耗时且不适合紧急护理和自动化凝血控制。由于可以在大约五分钟内测量血液样本中的蛋白质浓度,我们开发了个性化、现象学、快速、面向控制的模型,这些模型可以根据输入的血液蛋白质浓度预测 TEG 曲线输出,从而根据 TEG 曲线做出治疗决策。在这里,我们通过实验验证、机制验证和创伤患者凝血数据验证,准确预测、验证和解释了常见 TEG 检测(功能性纤维蛋白原、枸橼酸盐原生、血小板图谱和快速 TEG)的曲线和参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/875e/10770315/9b0dfda1b93f/41467_2023_44231_Fig1_HTML.jpg

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