Portable Device Measures Blood Coagulation Ability

A novel optical device allows rapid, comprehensive whole blood coagulation profiling in patients at elevated bleeding risk.

Developed at Massachusetts General Hospital (MGH; Boston, USA) and the Wellman Center for Photomedicine (Boston, MA, USA), the iCoagLab is a laser-based rheology device that illuminates a drop of blood placed into a disposable cartridge. The recalcified and kaolin-activated blood samples are tested using time-varying intensity fluctuation of laser speckle patterns in order to quantify the clot viscoelastic modulus during coagulation. The results are generated within minutes at the patient's bedside.

Coagulation parameters derived from clot viscoelasticity include reaction time, clot progression time, clot progression rate, and maximum clot strength. In a study involving whole blood samples from 270 patients undergoing conventional coagulation testing and the iCoagLab device, a good correlation was found between the iCoagLab and conventional thromboelastography (TEG) derived parameters, while the diagnostic specificity of iCoagLab (77%) was significantly higher than TEG (69%). The study was published in the June 2020 issue of Thrombosis and Haemostasis.

“Clinicians in the operating room or the ICU often walk a thin line to maintain the delicate balance between bleeding and coagulation,” said senior author Professor Seemantini Nadkarni, PhD, of the MGH Wellman Center for Photomedicine. “The iCoagLab innovation will likely advance clinical capability to rapidly identify patients with defective clotting at the point-of-care, assess risk of hemorrhage, and tailor treatments based on individual coagulation deficits to help prevent life-threatening bleeding in patients.”

“By rapidly and comprehensively permitting blood coagulation profiling the iCoagLab innovation is likely to advance the capability to identify patients with elevated risk for bleeding, with the ultimate goal of preventing life-threatening hemorrhage, “concluded lead author Markandey Tripathi, PhD, of the Wellman Center for Photomedicine. “Timely and accurate identification of impaired coagulation at the point-of-care can proactively identify bleeding risk and guide resuscitation, resulting in improved outcomes for patients.”

Blood viscosity is determined by plasma viscosity, hematocrit, and the mechanical properties of red blood cells (RBCs). As a result, blood behaves as a non-Newtonian fluid, and its viscosity varies with shear rate. Blood becomes less viscous at high shear rates, and increases when shear rate goes down and with RBC aggregability. The viscoelasticity of human blood is primarily due to the elastic energy that is stored in the deformation of RBCs.

Related Links:
Massachusetts General Hospital
Wellman Center for Photomedicine