Technology Advancements in Blood Coagulation Measurements for Point-of-Care Diagnostic Testing

Abstract

In recent years, blood coagulation monitoring has become crucial to diagnosing causes of hemorrhages, developing anticoagulant drugs, assessing bleeding risk in extensive surgery procedures and dialysis, and investigating the efficacy of hemostatic therapies. In this regard, advanced technologies such as microfluidics, fluorescent microscopy, electrochemical sensing, photoacoustic detection, and micro/nano electromechanical systems (MEMS/NEMS) have been employed to develop highly accurate, robust, and cost-effective point of care (POC) devices. These devices measure electrochemical, optical, and mechanical parameters of clotting blood. Which can be correlated to light transmission/scattering, electrical impedance, and viscoelastic properties. In this regard, this paper discusses the working principles of blood coagulation monitoring, physical and sensing parameters in different technologies. In addition, we discussed the recent progress in developing nanomaterials for blood coagulation detection and treatments which opens up new area of controlling and monitoring of coagulation at the same time in the future. Moreover, commercial products, future trends/challenges in blood coagulation monitoring including novel anticoagulant therapies, multiplexed sensing platforms, and the application of artificial intelligence in diagnosis and monitoring have been included.

Viscoelastic Hemostatic Assays: Moving from the Laboratory to the Site of Care—A Review of Established and Emerging Technologies

“…Several emerging technologies are currently in development for point-of-care hemostatic testing, including microfluidics, fluorescent microscopy, electrochemical sensing, photoacoustic detection, and micro/nano electromechanical systems (MEMS/NEMS) [28]. In the section below, we outline several new devices/technologies that are currently under investigation for use as viscoelastic hemostatic assays; however, these technologies may also have other applications, such as monitoring microfluid dynamics and shear force in coagulation [29][30][31][32][33][34].…”

Visualization and Measurements of Blood Cells Flowing in Microfluidic Systems and Blood Rheology: A Personalized Medicine Perspective

“…Owing to recent developments in microfluidic technology, several hemorheological point-of-care devices have been designed that allow the possibility of conducting extensive clinical studies using hemorheological measurements [ 6 , 33 ]. The field of microfluidics technology is characterized by the study and manipulation of fluids in microstructures at the submillimeter length scale and it has emerged as an important tool to be applied in many engineering and biomedical fields [ 34 ].…”

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

“…Outside the clinical laboratory there is an array of POCT devices available for the PT/INR test, some often combining the measurement of the aPTT and ACT in a single instrument (Table II). 19 Despite the availability of POCT devices in haemostasis testing, their widespread use for measuring the PT (other than monitoring the INR) to date is limited. 12…”