The viscoelastic properties and microstructure of the fibrin clot network are compromised in patients with coagulation abnormalities. In this study, we harness two novel optical approaches, iCoagLab and Spectrally Encoded Confocal Microscopy (SECM), to investigate how modifications in viscoelastic properties of blood clots are reflected in the microstructural features of the fibrin network in coagulopathic patients. We observe that blood clot viscoelasticity is directly related to fibrin density, fiber length, and fiber straightness of a fully polymerized fibrin network.
Rapidly changing coagulation status is a major challenge in managing and preventing bleeding in patients on mechanical circulatory support. Here, we apply iCoagLab, a hand-held coagulation sensing instrument for timely and comprehensive blood coagulation assessment in patients undergoing cardiac pump implantation. Our results confirm the high accuracy and precision of iCoagLab tests in quantifying key clotting parameters including clotting time, clot stiffness and clotting rate. These studies will help pave the way towards addressing bleeding complications at the point of treatment to potentially manage and prevent hemorrhagic events during mechanical circulatory support.
Prolonged cardiopulmonary bypass (CPB) exposure and excessive anticoagulation during cardiac surgical procedures frequently cause acute bleeding. Here we investigated the accuracy and precision of a novel optical sensor, iCoaglab, that utilizes a small volume of whole blood to comprehensively monitor blood coagulation in patients. Our results showed coagulation metrics, activated clotting times (ACT), maximum clot stiffness (MA), and fibrinolysis were highly correlated with standard-reference tests. In conclusion, iCoaglab uniquely affords comprehensive profiling of whole blood coagulation, potentially enabling the capability to identify coagulation impairments and predict bleeding during CPB.
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