A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood

The currently available point-of-care hemostasis tests are burdened by criticisms concerning the use of different activators and inhibitors and the lack of dynamic flow. These operating conditions may constitute an impediment to the determination of the patient’s hemostatic condition. Hence, the dif...

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Main Authors: Alessandro Foladore, Simone Lattanzio, Elisabetta Lombardi, Cristina Durante, Ekaterina Baryshnikova, Martina Anguissola, Lidia Rota, Marco Ranucci, Mario Mazzucato
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Biosensors
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Online Access:https://www.mdpi.com/2079-6374/14/11/518
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author Alessandro Foladore
Simone Lattanzio
Elisabetta Lombardi
Cristina Durante
Ekaterina Baryshnikova
Martina Anguissola
Lidia Rota
Marco Ranucci
Mario Mazzucato
author_facet Alessandro Foladore
Simone Lattanzio
Elisabetta Lombardi
Cristina Durante
Ekaterina Baryshnikova
Martina Anguissola
Lidia Rota
Marco Ranucci
Mario Mazzucato
author_sort Alessandro Foladore
collection DOAJ
description The currently available point-of-care hemostasis tests are burdened by criticisms concerning the use of different activators and inhibitors and the lack of dynamic flow. These operating conditions may constitute an impediment to the determination of the patient’s hemostatic condition. Hence, the diffusion of these tests in clinical practice is still limited to specific scenarios. In this work, we present a new method for analyzing the patient’s global hemostasis based on the visualization of the main components of the coagulation process and its computerized quantitative image analysis. The automated “Smart Clot” point-of-care system presents a micro-fluidic chamber in which whole blood flows, without the addition of any activator or inhibitor. In this micro-channel, platelet adhesion, activation and aggregation to the type I collagen-coated surface take place (primary hemostasis), leading to the production of endogenous thrombin on the surface of platelet aggregates and the consequent fibrin mesh and thrombus formation (secondary hemostasis). These observations are verified by inhibiting primary hemostasis with the antiplatelet drugs Indomethacin (−70% on platelet aggregation, −60% on fibrin(ogen) formation) and Tirofiban (complete inhibition of platelet aggregation and fibrin(ogen) formation) and secondary hemostasis with the antithrombin drugs Heparin (−70% on platelet aggregation, −80% on fibrin(ogen) formation) and Lepirudin (−80% on platelet aggregation, −90% on fibrin(ogen) formation). Smart Clot, through a single test, provides quantitative results concerning platelet aggregation and fibrin formation and is suitable for undergoing comparative studies with other coagulation point-of-care devices.
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spelling doaj-art-01ef3c27e47c496ca6b282cb32a7fccd2024-11-26T17:54:31ZengMDPI AGBiosensors2079-63742024-10-01141151810.3390/bios14110518A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole BloodAlessandro Foladore0Simone Lattanzio1Elisabetta Lombardi2Cristina Durante3Ekaterina Baryshnikova4Martina Anguissola5Lidia Rota6Marco Ranucci7Mario Mazzucato8Sedicidodici s.r.l., 33170 Pordenone, ItalySedicidodici s.r.l., 33170 Pordenone, ItalyStem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, ItalyStem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, ItalyDepartment of Cardiothoracic and Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Donato, 20097 San Donato Milanese, ItalyDepartment of Cardiothoracic and Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Donato, 20097 San Donato Milanese, ItalySedicidodici s.r.l., 33170 Pordenone, ItalyDepartment of Cardiothoracic and Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico, Policlinico San Donato, 20097 San Donato Milanese, ItalyStem Cell Unit, Department of Research and Advanced Cancer Diagnostic, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, ItalyThe currently available point-of-care hemostasis tests are burdened by criticisms concerning the use of different activators and inhibitors and the lack of dynamic flow. These operating conditions may constitute an impediment to the determination of the patient’s hemostatic condition. Hence, the diffusion of these tests in clinical practice is still limited to specific scenarios. In this work, we present a new method for analyzing the patient’s global hemostasis based on the visualization of the main components of the coagulation process and its computerized quantitative image analysis. The automated “Smart Clot” point-of-care system presents a micro-fluidic chamber in which whole blood flows, without the addition of any activator or inhibitor. In this micro-channel, platelet adhesion, activation and aggregation to the type I collagen-coated surface take place (primary hemostasis), leading to the production of endogenous thrombin on the surface of platelet aggregates and the consequent fibrin mesh and thrombus formation (secondary hemostasis). These observations are verified by inhibiting primary hemostasis with the antiplatelet drugs Indomethacin (−70% on platelet aggregation, −60% on fibrin(ogen) formation) and Tirofiban (complete inhibition of platelet aggregation and fibrin(ogen) formation) and secondary hemostasis with the antithrombin drugs Heparin (−70% on platelet aggregation, −80% on fibrin(ogen) formation) and Lepirudin (−80% on platelet aggregation, −90% on fibrin(ogen) formation). Smart Clot, through a single test, provides quantitative results concerning platelet aggregation and fibrin formation and is suitable for undergoing comparative studies with other coagulation point-of-care devices.https://www.mdpi.com/2079-6374/14/11/518coagulationpoint of careimage analysisshear rateplateletsfibrin
spellingShingle Alessandro Foladore
Simone Lattanzio
Elisabetta Lombardi
Cristina Durante
Ekaterina Baryshnikova
Martina Anguissola
Lidia Rota
Marco Ranucci
Mario Mazzucato
A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood
Biosensors
coagulation
point of care
image analysis
shear rate
platelets
fibrin
title A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood
title_full A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood
title_fullStr A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood
title_full_unstemmed A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood
title_short A New Shear-Stress-Based Point-of-Care Technology for Evaluation of the Hemostatic Pattern in Whole Blood
title_sort new shear stress based point of care technology for evaluation of the hemostatic pattern in whole blood
topic coagulation
point of care
image analysis
shear rate
platelets
fibrin
url https://www.mdpi.com/2079-6374/14/11/518
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