As the applications of this technology are focused within the clinical and life sciences, a thorough understanding of the associated biological impact imposed by these manipulation techniques is necessary.The desire to manipulate suspended matter within microfluidic systems has inspired a range of techniques both passive [5,19,20] and active. [21,22] Passive approaches rely heavily on the geometry of the microfluidic channels and inertial forces. Flow profiles are altered by the introduction of sudden expansions and contractions, weirs and pillars to impede and divert the flow into desired streamlines. This reliance on the resultant flow profile restricts the flexibility of the chip, being single task specific. In contrast, active methods are significantly more robust, capable of on-demand actuation and offer the ability to change functionality ad-hoc, leading to an increased selectivity. To this end, a range of active methods have been developed using magnetic, [23,24] optical, [25,26] electrical [16,27] and acoustic [28][29][30] excitation.Acoustofluidics is the use of acoustic forces to manipulate suspended matter within microfluidics, [31,32] and has the advantage of uniquely combining ease of on-chip integration and simple, yet dextrous establishment of force fields in a noncontact manner. [29,33,34] As a direct result, it has been extensively used to capture, [33,35] pattern, [36][37][38] and sort particles, [15,34,39] cell sonoporation, [40] synthesize nanomaterials, [41] as well as to mix fluids. [42,43] Although acoustofluidics has been widely accepted as a biocompatible technique, substantiated with cell viability studies; [44][45][46][47][48] there have been no extensive viability studies at elevated frequencies (30-600 MHz). Indeed, typically studies are corroborated with a single viability method, most commonly live/dead staining, [6,[49][50][51] or trypan blue exclusion [52,53] and in some instances proliferation studies (MTT). [36] In contrast to these singular approaches, in passive microfluidic systems in which cells are predominantly subjected to shear forces arising from the flow field, a wide range of multifaceted cell viability studies [54] have been conducted showing, for example, sheardependent regulation of the von Willebrand factor of human umbilical vein endothelial cells [55] and the potential for circulating tumor cell apoptosis at high shear levels. [56] This lack of biological knowledge may result in potential unrecognized adverse effects (i.e., "false positives"), or Acoustic fields are capable of manipulating biological samples contained within the enclosed and highly controlled environment of a microfluidic chip in a versatile manner. The use of acoustic streaming to alter fluid flows and radiation forces to control cell locations has important clinical and life science applications. While there have been significant advances in the fundamental implementation of these acoustic mechanisms, there is a considerable lack of understanding of the associated biological effects on cells. ...