Microfluidics in Haemostasis: A Review

Abstract

Haemostatic disorders are both complex and costly in relation to both their treatment and subsequent management. As leading causes of mortality worldwide, there is an ever-increasing drive to improve the diagnosis and prevention of haemostatic disorders. The field of microfluidic and Lab on a Chip (LOC) technologies is rapidly advancing and the important role of miniaturised diagnostics is becoming more evident in the healthcare system, with particular importance in near patient testing (NPT) and point of care (POC) settings. Microfluidic technologies present innovative solutions to diagnostic and clinical challenges which have the knock-on effect of improving health care and quality of life. In this review, both advanced microfluidic devices (R&D) and commercially available devices for the diagnosis and monitoring of haemostasis-related disorders and antithrombotic therapies, respectively, are discussed. Innovative design specifications, fabrication techniques, and modes of detection in addition to the materials used in developing micro-channels are reviewed in the context of application to the field of haemostasis.

2021 Update of the International Council for Standardization in Haematology Recommendations for Laboratory Measurement of Direct Oral Anticoagulants

“…The widespread use of DOACs and the need for urgent determination in aforementioned specific clinical situations have spurred several investigators and manufacturers to pursue POCT technologies for measuring (or quantifying) DOAC effect. [96][97][98] Included are microfluidic technologies [98][99][100][101] and surface acoustic wave (SAW) technologies. 102 Although the preliminary findings are promising, shortcomings include use of an animal model, 101 or in vitro enriched DOAC blood, 99 data from a small series of patients 99,100 and only a limited number of DOACs assessed.…”

Point-of-care testing : is it a paradox in international normalised ratio measurements?

“…There is no doubt as the rise in oral antithrombotic therapy intensifies, innovative approaches to monitor this therapy will have to be developed. An example is the more convenient and cost-effective microfluidics technology 19,89 that has become the standard in POCT INR measurement. 19,86,89 The future expectations regarding this technology are further commercialisation of next-generation POCT INR devices.…”

“…An example is the more convenient and cost-effective microfluidics technology 19,89 that has become the standard in POCT INR measurement. 19,86,89 The future expectations regarding this technology are further commercialisation of next-generation POCT INR devices. This will depend on a number of factors such as ease of use, reasonable costs and reliability in terms of accuracy, sensitivity and specificity.…”

“…This will allow healthcare providers to perform prompt warfarin dosing adjustment as well as face-to-face education with the patient. 86,89 Finally, collaboration between the various manufacturers, the clinical pathology laboratories, primary healthcare facilities and performance checks on POCT INR devices (using both IQC and EQA) are vital in order to maintain quality standards.…”

Hemp-Based Microfluidics

“…Microfluidic analytical devices have a wide range of applications in point-of-care diagnosis [ 50 , 51 , 52 , 53 , 54 , 55 , 56 ], clinical tests [ 57 , 58 , 59 , 60 , 61 ], food safety measurements [ 62 ], and environmental protection [ 63 , 64 ]. Although conventional laboratory-based analytical devices can be employed for these applications, microfluidic devices are designed to be portable and affordable, and can perform multiple tests on one device [ 65 , 66 ]. Laser etching [ 67 ], photolithography [ 68 , 69 ], plasma treatment [ 70 ], and 3D printing [ 71 , 72 , 73 , 74 , 75 ] are widely used to fabricate polymeric, glass-based, and silicone-based microfluidic devices [ 76 , 77 ].…”