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Real-time intraoperative monitoring of blood coagulability via coherence-gated light scattering

Abstract

When characterizing dynamic processes, ergodicity—that is, the equivalence of time averages and of averages over a system’s possible microstates—is often invoked. Yet many complex social, economic and material systems are such that practical observations cannot survey the entire ensemble of microstates. In the case of non-ergodic fluids, their slow structural dynamics makes such an approach prohibitive. Blood is a prominent example of a non-ergodic, complex fluid for which today’s standards for coagulation tests in vivo are chemically induced offline assays. Here, we show that heterodyne amplification—that is, amplification of a signal by frequency conversion—combined with suitable control of spatiotemporal coherence permits measurements of non-stationary dynamics in non-ergodic, complex media. By taking advantage of this approach, we developed an optical-fibre-based tool that can be directly incorporated into standard vascular-access devices for real-time monitoring of blood coagulability in the operating room.

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Figure 1: Three-dimensional spatiotemporal coherence-gated DLS.
Figure 2: PSDs measured with the MMF-based technique from probe nanoparticles caged within a polymer network.
Figure 3: Typical PSDs of signal fluctuations arising from light scattering in whole blood at different stages during cardiovascular surgery, measured by spatiotemporal coherence-gated DLS.
Figure 4: Correlation between incremental time-point differences of the log-slope of the PSD and of ACT.
Figure 5: An all-fibre realization of the spatiotemporal coherence-gated DLS technique
Figure 6: Time evolution of power-spectral frequencies of whole blood measured continuously via spatiotemporal coherence-gated DLS during two hours of CPB for a single patient.

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Acknowledgements

This work was partially supported by the National Institutes of Health and the National Heart, Lung and Blood Institute under grant number 5R21HL124486.

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Contributions

A.D. and W.M.D.C. planned the project. A.D. and J.R.G.-S. designed the experimental technique. W.M.D.C. and R.A.-M. designed the clinical study and the medical protocols. J.R.G.-S. and R.A.-M. contributed to data collection. J.R.G.-S. and A.D. analysed the data. All authors contributed to interpreting the data and to drafting the article.

Corresponding author

Correspondence to A. Dogariu.

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The authors declare no competing financial interests.

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Guzman-Sepulveda, J., Argueta-Morales, R., DeCampli, W. et al. Real-time intraoperative monitoring of blood coagulability via coherence-gated light scattering. Nat Biomed Eng 1, 0028 (2017). https://doi.org/10.1038/s41551-017-0028

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