Prediction of Thrombus Formation within an Oxygenator via Bioimpedance Analysis

Biosensors, vol. 14, pp. 511

Abstract

Blood clot formation inside the membrane oxygenator (MO) remains a risk in extracorporeal membrane oxygenation (ECMO). It is associated with thromboembolic complications and normally detectable only at an advanced stage. Established clinical monitoring techniques lack predictive capabilities, emphasizing the need for refinement in MO monitoring towards an early warning system. In this study, an MO was modified by integrating four sensor fibers in the middle of the hollow fiber mat bundle, allowing for bioimpedance measurement within the MO. The modified MO was perfused with human blood in an in vitro test circuit until fulminant clot formation. The optical analysis of clot residues on the extracted hollow fibers showed a clot deposition area of 51.88% ± 14.25%. This was detectable via an increased bioimpedance signal with a significant increase 5 min in advance to fulminant clot formation inside the MO, which was monitored by the clinical gold standard (pressure difference across the MO (dp-MO)). This study demonstrates the feasibility of detecting clot growth early and effectively by measuring bioimpedance within an MO using integrated sensor fibers. Thus, bioimpedance may even outperform the clinical gold standard of dp-MO as a monitoring method by providing earlier clot detection.

Authors 10

1. Jana Korte Aachen Department of Anesthesiology, Medical Faculty

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany

2. Tobias Lauwigi Aachen Institut für Textiltechnik

   RWTH Aachen University

   Affiliation as printed

   Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany

3. Alexander Theißen Aachen Department of Anesthesiology, Medical Faculty

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany

4. Lasse J. Strudthoff Aachen Medical Faculty Institute of Applied Medical Engineering Department of Cardiovascular Engineering

   RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany

5. Jannis Focke Aachen Medical Faculty Institute of Applied Medical Engineering Department of Cardiovascular Engineering

   RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany

6. Sebastian Victor Jansen Aachen Medical Faculty Institute of Applied Medical Engineering Department of Cardiovascular Engineering

   RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany

7. Thomas Gries Aachen Institut für Textiltechnik

   RWTH Aachen University

   Affiliation as printed

   Institut für Textiltechnik (ITA), RWTH Aachen University, 52074 Aachen, Germany

8. Rolf Rossaint Aachen Department of Anesthesiology, Medical Faculty

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany

9. Christian Bleilevens Aachen Department of Anesthesiology, Medical Faculty

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany

10. Patrick Winnersbach corresponding Aachen Department of Anesthesiology, Medical Faculty

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany