TraumaChek: A Field-Deployable Dielectric Coagulometer for Comprehensive Hemostatic Assessment in Remote Damage Control Resuscitation (RDCR)
Abstract
Background: Uncontrolled bleeding due to trauma and the corresponding abnormalities of blood coagulation, collectively called trauma-induced coagulopathy, are leading causes of death in our military, accounting for ~90% of combat-related deaths. These abnormalities in blood coagulation happen very quickly, typically within minutes to hours after injury, and need to be treated as early as possible to improve chances of survival. Trauma-induced coagulopathy is complex and involves dysfunction of multiple steps within blood coagulation process, either individually or in combination. Each dysfunction within coagulation process requires a specific treatment in terms of transfusion of a blood component such as blood, plasma, or platelets. Therefore, a comprehensive assessment of blood coagulation is crucial to detect trauma-induced coagulopathy and to guide appropriate treatment. However, access to specialized laboratory tests to achieve a comprehensive assessment of blood coagulation may not be possible in a timely manner, even in a hospital setting. Compounding this is the fact that these tests are not available in the pre-hospital or battlefield settings. Within some hospitals and trauma centers, a benchtop device for viscoelastic measurement of whole blood can be used to provide a near-patient assessment of trauma-induced coagulopathy. These devices can provide information on the specific dysfunction of the blood coagulation process and are useful in guiding the appropriate transfusion strategy for increased chance of survival and reduced use of blood products. However, they are bulky mechanical instruments that are sensitive to vibration and therefore are not suited for use in pre-hospital settings such as in the battlefield or during air or ground transport. As battlefields and operations become increasingly remote, disaggregated, and contested, the survival of injured combat personnel will require more advanced medical care to be pushed farther to the frontlines and for medical units to be equipped to manage the delayed complications of trauma that have traditionally been managed at fixed institutions. It is clear that a significant challenge remains regarding technologies that allow on-field comprehensive blood coagulation assessment while providing design needs of portability, small carry-weight, and rapid readout for detecting trauma-induced coagulopathy and guiding transfusion strategies. In this framework, a portable, handheld device for early, rapid, and comprehensive assessment of coagulopathy so that proper transfusion strategies can be implemented under informed guidance would be of tremendous benefit, not only in combat casualty care but also in civilian pre-hospital settings (e.g., ambulance, air transport). Problem: Operational and austere settings present significant challenges in evaluating and monitoring a patient’s coagulation status to guide appropriate transfusion strategies with the goal of increased chance of survival and reduced use of scarce blood products. Objectives: The long-term goal of this project is to establish TraumaChek – a miniaturized, multichannel, portable, handheld blood coagulation analyzer based on the principles of dielectric spectroscopy – for early, rapid, and comprehensive assessment of trauma-induced coagulopathy. Dielectric spectroscopy is an electronic measurement technique, and we have previously shown that dielectric spectroscopy measurements on whole blood in a microfluidic sensor are sensitive to various aspects of trauma-induced coagulopathy. We will build on our previous research and develop a multichannel sensor surface-modified with reagents selected to enhance detection of principal aspects of trauma-induced coagulopathy. Studies with animal and human blood obtained through approved protocols will be used for evaluating and validating TraumaChek performance. Specifically, studies will be performed with healthy human blood processed to simulate various blood coagu
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110780
Entities
People
- Matthew D Neal
Organizations
- United States Army
- University of Pittsburgh