Monitoring systems and quantitative measurement of biomolecules for the management of Trauma

Abstract

Continued high morbidity and complications due to trauma related hemorrhage underscores the fact that our understanding of the detailed molecular events of trauma are inadequate to bring life-saving changes to practice. The current state of efficacy and advances in biomedical microdevice technology for trauma diagnostics concerning hemorrhage and hemorrhagic shock was considered with respect to vital signs and metabolic biomarkers. Tachycardia and hypotension are markers of hemorrhagic shock in decompensated trauma patients. Base deficit has been predicative of injury severity at hospital admission. Tissue oxygen saturation has been predicative of onset of multiple organ dysfunction syndrome. Blood potassium levels increase with onset of hemorrhagic shock. Lactate is a surrogate for tissue hypoxia and its clearance predicts mortality. Triage glucose measurements have been shown to be specific in predicting major injuries. No vital sign has yet to be proven effective as an independent predictor of trauma severity. Point of care (POC) devices allow for rapid results, easy sample preparation and processing, small sample volumes, small footprint, multifunctional analysis, and low cost. Advances in the field of in-vivo biosensors has provided a much needed platform by which trauma related metabolites can be monitored easily, rapidly and continuously. Multi-analyte monitoring biosensors have the potential to explore areas still undiscovered in the realm of trauma physiology.

Toward a hemorrhagic trauma severity score: fusing five physiological biomarkers

“…1 Immediate and continual measurement of key biomarkers may serve as a “gauge” for identifying shock states. Discrete values from the five indwelling biosensors are fused into a single actionable Hemorrhage Intensive Severity and Survivability (HISS) score [ 1 ]. This score is further stratified into five, color-coded levels, ‘SEVERE (4)’ being the most critical and ‘LOW (0)’ corresponding to expectant …”

“…Trauma accounts for 47% of mortalities in individuals 1–46 years of age in the United States [ 1 , 2 ]. Trauma-induced hemorrhage with its attendant peripheral vasoconstriction [ 3 , 4 ] insulin resistance [ 5 ], hyperlactatemia, [ 6 – 8 ] acidosis [ 9 ], hyperkalemia [ 10 , 11 ] and hypoxia can rapidly lead to death or may be followed by Multiple Organ Dysfunction Syndrome (MODS), a consequence of a “cytokine storm”, which can also be fatal [ 9 , 12 ].…”

Molecular Modeling and Simulation Tools in the Development of Peptide-Based Biosensors for Mycotoxin Detection: Example of Ochratoxin

“…Over the past few decades, the Bioelectronics, Biosensors and Biochips (C3B ® ) group has been engineering a wide range bioanalytical microsystems in the service of human health and medicine [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Recently, our group has also been involved in the development of peptide-based optical and electrochemical biosensors for continual OTA monitoring [ 28 , 29 , 30 , 31 , 32 ].…”

Integrated Microfluidic Nucleic Acid Isolation, Isothermal Amplification, and Amplicon Quantification

“…In the last decade there has been considerable interest and research in addressing the needs and opportunities for on-site Nucleic Acid-based Tests (NATs) [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18]. These tests are also termed Nucleic Acid Amplification Tests (NAATs) when incorporating sequence-specific enzymatic amplification of nucleic acids such as PCR (polymerase chain reaction), or molecular diagnostics when used in a medical context.…”