Clinical evaluation of whole blood prothrombin time (PT) and international normalized ratio (INR) using a Laser Speckle Rheology sensor

Tripathi, Markandey M.; Egawa, Satoru; Wirth, Alexandra G.; Tshikudi, Diane M.; Cott, Elizabeth M. Van; Nadkarni, Seemantini K.

doi:10.1038/s41598-017-08693-5

Cited by 36 publications

(44 citation statements)

References 44 publications

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“…The results similarly showed that PT-INR measured by LSR strongly correlated with laboratory values of PT-INR (r ¼ 0.94, p < 0.001), with only a negligible measurement bias of 0.3 seconds. 33 These observations confirm that the LSR rapidly and accurately measures the response of various anticoagulants with results equivalent to CCTs, standard TEG, and other point-of-care assays within seconds to minutes, using just a 40-μL drop of whole blood. Given the small blood volume and potential for push-of-a-button operation, LSR may provide a unique opportunity for patient self-testing via a finger-stick draw.…”

Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrsupporting

confidence: 68%

“…The viscoelastic modulus of clotting blood can be subsequently realized by measuring the displacements of light scattering blood cells from the time evolution of intensity fluctuations of speckle patterns. 26,27 Clinical testing in over 500 patients to date have confirmed the accuracy of the LSR approach in assessing PT, ACT, fibrinogen, 27,32,33 as well as global hemostatic metrics of coagulation and fibrinolytic pathways, as reviewed below. 32,34 mechanical rheometer that quantifies the ratio of an applied stress to induced strain in the specimen, over an oscillation frequency (ω) range, to calculate the frequency-dependent viscoelastic modulus, G Ã (ω).…”

Section: Analyzer Descriptionmentioning

confidence: 90%

“…2E). 33 The LSR sensor (dimensions: 5.2″ Â 3.6″ Â 2.5″) weighs less than 1 lb and can easily be hand-held to permit portability, opening the opportunity for rapid near-patient global coagulation testing.…”

Section: Analyzer Descriptionmentioning

confidence: 99%

“…(E) Hand-held and battery-operated LSR device. 33 to VKAs. 39,[48][49][50] It was previously thought that the more predictable pharmacokinetic profile of DOACs would obviate the need for routine coagulation testing.…”

Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrmentioning

confidence: 99%

“…Because aPTT (measured above) is not the traditional test used to monitor warfarin patients, a separate study was performed to evaluate whether LSR accurately probed coagulation status via the extrinsic pathway to accurately assess PT-INR. 33 In this case, whole blood samples from 60 warfarin-treated patients (INR range: 0.95-2.71) were measured by LSR and whole blood coagulation was initiated using thromboplastin. The results similarly showed that PT-INR measured by LSR strongly correlated with laboratory values of PT-INR (r ¼ 0.94, p < 0.001), with only a negligible measurement bias of 0.3 seconds.…”

Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrmentioning

confidence: 99%

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Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Nadkarni

2019

Semin Thromb Hemost

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Delays in identifying internal bleeding are life-threatening, thus underscoring the need for rapid and comprehensive coagulation profiling at the bedside. The authors review a novel optical coagulation profiler that measures several coagulation metrics including prothrombin time, activated clotting time, clot polymerization rate (α-angle), clot stiffness (maximum amplitude), fibrinolysis (LY), and platelet function, using a single multifunctional instrument. The optical profiler is based on the principles of Laser Speckle Rheology that quantifies tissue viscoelasticity from light scattering patterns called laser speckle. To operate the optical profiler, whole blood (40 μL) is loaded into a disposable cartridge, laser speckle patterns are recorded via a camera, and the viscoelasticity of clotting blood is estimated from speckle intensity fluctuations. By monitoring alterations in viscoelastic moduli over time during clot initiation, thrombin generation, fibrin crosslinking, clot stabilization, and LY, global coagulation parameters are obtained within 10 minutes using a drop of whole blood. Clinical testing in over 500 patients to date has confirmed the accuracy of the optical profiler for comprehensively assessing coagulation status against conventional coagulation tests and thromboelastography. Recent studies have further demonstrated the capability to quantify platelet aggregation induced by adenosine diphosphate in a drop of platelet-rich-plasma in the absence of applied shear stress. Together, these studies demonstrate that global coagulation profiling in addition to platelet function may be accomplished using a single multifunctional device. Thus, by enabling rapid and comprehensive coagulation and platelet function profiling at the bedside, the optical profiler will likely advance the capability to identify and manage patients with an elevated risk for hemorrhage.

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Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrsupporting

confidence: 68%

Section: Analyzer Descriptionmentioning

confidence: 90%

Section: Analyzer Descriptionmentioning

confidence: 99%

Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrmentioning

confidence: 99%

Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrmentioning

confidence: 99%

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Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Nadkarni

2019

Semin Thromb Hemost

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Ultrathin and Robust Hydrogel Coatings on Cardiovascular Medical Devices to Mitigate Thromboembolic and Infectious Complications

Parada

Riley

et al. 2020

Adv Healthcare Materials

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Thromboembolic and infectious complications stemming from the use of cardiovascular medical devices are still common and result in significant morbidity and mortality. There is no strategy to date that effectively addresses both challenges at the same time. Various surface modification strategies (e.g., silver, heparin, and liquid-impregnated surfaces) are proposed yet each has several limitations and shortcomings. Here, it is shown that the incorporation of an ultrathin and mechanically robust hydrogel layer reduces bacterial adhesion to medical-grade tubing by 95%. It is additionally demonstrated, through a combination of in vitro and in vivo tests, that the hydrogel layer significantly reduces the formation and adhesion of blood clots to the tubing without affecting the blood's intrinsic clotting ability. The adhesion of clots to the tubing walls is reduced by over 90% (in vitro model), which results in an ≈60% increase in the device occlusion time (time before closure due to clot formation) in an in vivo porcine model. The advantageous properties of this passive coating make it a promising surface material candidate for medical devices interfacing with blood. Cardiovascular devices such as intravascular (IV) catheters are essential for the diagnosis and treatment of many acute and chronic

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Gender-specific differences in haemostatic parameters and their influence on blood loss in bimaxillary surgery

et al. 2022

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Objective The objectives of this prospective cohort study were to establish gender-related differences in blood loss and haemostatic profiles associated with bimaxillary surgery. In addition, we aimed to identify if any gender differences could be established which might help predict blood loss volume. Materials and methods Fifty-four patients (22 males; 32 females) undergoing bimaxillary surgery for skeletal dentofacial deformities were eligible for inclusion. Blood samples were taken 1 day preoperatively and 48 h postoperatively for detailed gender-specific coagulation analysis incorporating global coagulation assays (endogenous thrombin potential) and specific coagulation parameters. Blood loss was measured at two different time points: (1) the end of surgery, visible intraoperative blood loss (IOB) using ‘subtraction method’; and (2) 48 h postoperatively perioperative bleeding volume (CBL-48 h) using ‘haemoglobin-balance method’ and Nadler’s formula. Correlation and regression analyses were performed to identify relevant parameters affecting the amount of blood loss. Results Significant differences in IOB and CBL-48 h were observed (p < 0.001). Men had higher IOB versus women, lacking statistical significance (p = 0.056). In contrast, men had significantly higher CLB-48 h (p = 0.019). Reduced CBL-48 h was shown to be most closely associated with the level of Antithrombin-III being decreased in females. Conclusions Male gender is associated with higher IOB and CBL-48 compared with females. Gender does not affect IOB regarding haemostatic profile but does correlate strongly with procedure length. Conversely, CBL-48 is closely associated with gender-specific imbalances in the anticoagulant system. Clinical relevance Knowledge of gender-related differences will help clinicians establish predictive factors regarding excessive blood loss in orthognathic surgery and identify at-risk patients.

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Clinical evaluation of whole blood prothrombin time (PT) and international normalized ratio (INR) using a Laser Speckle Rheology sensor

Cited by 36 publications

References 44 publications

Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Ultrathin and Robust Hydrogel Coatings on Cardiovascular Medical Devices to Mitigate Thromboembolic and Infectious Complications

Gender-specific differences in haemostatic parameters and their influence on blood loss in bimaxillary surgery

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