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Monitor Using Light Replaces Blood Test During Surgery

BioPhotonics
Jun 2017
ORLANDO, Fla. — Monitoring a surgical patient’s blood with light could provide real-time status updates during life-and-death operations and could replace the need for doctors to wait while blood is drawn and tested.

The blood-monitoring device taps directly into the heart-lung machine used to circulate blood during a patient's surgery.
 The blood-monitoring device taps directly into the heart-lung machine used to circulate blood during a patient's surgery. Courtesy of University of Central Florida.

Scientist and professor Aristide Dogariu from the University of Central Florida’s College of Optics & Photonics developed the novel technology, which uses an optical fiber to beam light through a patient’s blood. The device connects directly into the tubes of a heart-lung machine and detects the light as it bounces back.

The technology can alert doctors at the first sign of clotting, and provide nonstop information throughout a long procedure.

"It provides continuous feedback for the surgeon to make a decision on medication," said Dogariu. "That is what's new. Continuous, real-time monitoring is not available today. That is what our machine does, and in surgeries that can last for hours, this information can be critical."

During surgery, physicians are wary of the patient's blood coagulating, or clotting, too quickly. A clot can lead to life-threatening conditions such as stroke or pulmonary embolism. Coagulation is of particular concern during cardiovascular surgery, when a clot can shut down the heart-lung machine used to circulate the patient's blood.

Light introduced through an optical fiber can determine whether a patient's blood is coagulating by measuring the vibration of red blood cells.
 Light introduced through an optical fiber can determine whether a patient's blood is coagulating by measuring the vibration of red blood cells. Courtesy of Andrii Pshenychnyi.

Doctors administer blood-thinning medication to prevent coagulation. But every 20-30 minutes, blood must be withdrawn and taken to a lab for a test that can take up to 10 minutes. Dr. William DeCampli, chief of pediatric cardiac surgery at Arnold Palmer Hospital for Children, helped develop the technology that gives results in real-time.

"I absolutely see the technique having potential in the intensive care setting, where it can be part of saving the lives of critically ill patients with all kinds of other disorders," said DeCampli.

The device works by constantly interpreting the light’s back-scatter to determine how rapidly red blood cells are vibrating. Slow vibration is a sign that blood is coagulating.

Over the past year, DeCampli successfully tested the technology during cardiac surgeries on 10 infants at Arnold Palmer Hospital for Children in Orlando.

Their proof-of-concept study has been published in the journal Nature Biomedical Engineering (doi: 10.1038/s41551-017-0028). A larger study is in the works.

GLOSSARY
optical fiber
A thin filament of drawn or extruded glass or plastic having a central core and a cladding of lower index material to promote total internal reflection (TIR). It may be used singly to transmit pulsed optical signals (communications fiber) or in bundles to transmit light or images.  
Biophotonicslasersfiber opticsoptical fiberResearch & Technologyeducationlight sourcesUniversity of Central FloridaCollege of Optics and PhotonicsAristide DogariuDr. William DeCampliinfantsheart surgeryTest & MeasurementBioScan

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