Measurement of blood viscoelasticity during clotting provides a direct metric of haemostatic conditions. Therefore, technologies that quantify blood viscoelasticity at the point-of-care are invaluable for diagnosing coagulopathies. We present a new approach, Optical Thromboelastography (OTEG) that measures the viscoelastic properties of coagulating blood by evaluating temporal laser speckle fluctuations, reflected from a few blood drops. During coagulation, platelet-fibrin clot formation restricts the mean square displacements (MSD) of scatterers and decelerates speckle fluctuations. Cross-correlation analysis of speckle frames provides the speckle intensity temporal autocorrelation, g2(t), from which MSD is deduced and the viscoelastic modulus of blood is estimated. Our results demonstrate a close correspondence between blood viscoelasticity evaluated by OTEG and mechanical rheometry. Spatio-temporal speckle analyses yield 2-dimensional maps of clot viscoelasticity, enabling the identification of micro-clot formation at distinct rates in normal and coagulopathic specimens. These findings confirm the unique capability of OTEG for the rapid evaluation of patients’ coagulation status and highlight the potential for point-of-care use.
Spatial maps of blood viscoelasticity index, G, during clotting obtained from a normal patient (top row) and a hypo-coagulable patient with low levels of clotting factors (bottom row) at 0, 1, 14, and 30 minutes after kaolin activation. Micro-clots of significant G values appear at early times (~1 min) and continue to progress to form a large blood clot over 30 min in the normal patient. In contrast, in the hypo-coagulable sample, micro-clots of comparable G are only visible at 14 min and the extent and overall clot strength is considerably reduced compared to the normal patient even at 30 min. Scale bars are 100 μm long. These results demonstrate the high sensitivity and spatial resolution of OTEG for detecting incipient micro-clots during very early stages of clot formation in patients.