Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany.
Biosensors (Basel). 2024 Oct 18;14(10):511. doi: 10.3390/bios14100511.
Blood clot formation inside the membrane oxygenator (MO) remains a risk in extracorporeal membrane oxygenation (ECMO). It is associated with thromboembolic complications and normally detectable only at an advanced stage. Established clinical monitoring techniques lack predictive capabilities, emphasizing the need for refinement in MO monitoring towards an early warning system. In this study, an MO was modified by integrating four sensor fibers in the middle of the hollow fiber mat bundle, allowing for bioimpedance measurement within the MO. The modified MO was perfused with human blood in an test circuit until fulminant clot formation. The optical analysis of clot residues on the extracted hollow fibers showed a clot deposition area of 51.88% ± 14.25%. This was detectable via an increased bioimpedance signal with a significant increase 5 min in advance to fulminant clot formation inside the MO, which was monitored by the clinical gold standard (pressure difference across the MO (dp-MO)). This study demonstrates the feasibility of detecting clot growth early and effectively by measuring bioimpedance within an MO using integrated sensor fibers. Thus, bioimpedance may even outperform the clinical gold standard of dp-MO as a monitoring method by providing earlier clot detection.
在体外膜肺氧合（ECMO）中，膜氧合器（MO）内部的血栓形成仍然是一个风险。它与血栓栓塞并发症有关，通常只能在晚期检测到。现有的临床监测技术缺乏预测能力，这强调了需要对 MO 监测进行改进，以实现早期预警系统。在这项研究中，通过在中空纤维束的中间集成四个传感器纤维，对 MO 进行了改进，从而可以在 MO 内进行生物阻抗测量。在一个测试回路中，用人体血液灌注改良后的 MO，直到形成迅猛的血栓。从提取的中空纤维上的血栓残留物的光学分析表明，血栓沉积面积为 51.88%±14.25%。通过生物阻抗信号的增加可以检测到这一点，与 MO 内迅猛血栓形成相比，这可以提前 5 分钟检测到，而这是由临床金标准（MO 两端的压差（dp-MO））监测到的。这项研究表明，通过使用集成传感器纤维测量 MO 内的生物阻抗，可以早期和有效地检测到血栓生长。因此，生物阻抗甚至可能优于 dp-MO 的临床金标准，因为它可以更早地检测到血栓。
