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Early Blood Clot Detection Using Forward Scattering Light Measurements Is Not Superior to Delta Pressure
Anna Fischbach1, Michael Lamberti2, Julia Alexandra Simons1
1Department of Anesthesiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Biosensors
|December 22, 2023
Summary
Forward scattered light (FSL) measurements failed to detect early blood clots in an extracorporeal membrane oxygenator circuit. Current pressure monitoring remains the gold standard for identifying significant thrombus formation during ECMO therapy.
Area of Science:
- Biomedical Engineering
- Medical Device Technology
- Cardiovascular Research
Background:
- Thrombus formation in extracorporeal membrane oxygenators (ECMO) is a critical complication, leading to life-threatening thromboembolism.
- Current clinical practice relies on pressure difference (ΔP) monitoring, which fails to detect early-stage or small blood clots.
- An unmet need exists for sensitive sensors capable of early detection of blood clots during ECMO therapy to mitigate patient risks.
Purpose of the Study:
- To evaluate the efficacy of forward scattered light (FSL) measurements for early blood clot detection in ECMO circuits.
- To compare the sensitivity of FSL measurements against the current gold standard of pressure monitoring (ΔP) for clot detection.
Main Methods:
- An in vitro test circuit with a custom-made chamber was utilized, circulating heparinized human whole blood.
- Forward scattered light (FSL) measurements were performed using strategically placed LEDs and photodiodes.
- Pressure monitors recorded the pressure difference (ΔP) across the test chamber to detect thrombus formation.
Main Results:
- Despite modifications to LED placement, FSL measurements did not reliably detect blood clots in the in vitro ECMO circuit.
- Pressure monitoring (ΔP) successfully identified significant clot formation in all 11 independent experimental runs.
- FSL measurements were found to be inferior to pressure monitoring for detecting thrombus in this ECMO model.
Conclusions:
- Forward scattered light (FSL) measurement is not a suitable method for early blood clot detection in ECMO circuits.
- Current pressure monitoring (ΔP) remains the clinical standard for detecting significant thrombus formation during ECMO therapy.
- Further research is needed to develop novel sensors for early clot detection in ECMO to improve patient safety.
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