Five million people around the world die of trauma on an annual basis. Up to 20% of these deaths are preventable with better control bleeding. In these types of traumatic injury, the incidences of coagulation abnormalities are high. For example, natural supplies of proteins such as Factor VII are quickly depleted after trauma, which can quickly lead to hemorrhage-related death. Detecting these abnormalities quickly after the trauma often can be a predictor of the patient's mortality. These diagnostics can be a decision aid for providers and provide feedback for lifesaving actions, such as transfusions.
Although techniques such as prothrombin time (PT) and partial thromboplastin time (PTT) can test coagulation, only the first state of coagulation and plasma hemostasis are tested rather than coagulocompetence. In addition it has been shown that PT and PTT tests do not predict coagulation abnormalities as effectively as coagulation profiles, such as thrombelastography (TEG) shown in
Other coagulation profiling techniques such as thrombelastography and rotational thromboelastometry (ROTEM) shown in
In order to most effectively treat traumatic injuries, it is critical to diagnose coagulation abnormalities at the POI, ideally by first responders such as paramedic and emergency medical technicians (EMT) (
Needs exist for improved base medical analysers and coagulation profilers.
The invention solves the existing problems by providing disposable cartridges for new base medical analysers and coagulation profiles. That can be available to be quickly used.
A primary device of the invention is a new cartridge based biological microelectromechanical system (BioMEMS) that rotates back and forth in a circular motion in direct contact to a blood sample, while the blood coagulates. This rotation changes over time as the blood coagulates in the sample. The change in motion is analyzed through a video camera (in one case an iPhone camera) and then is plotted to show an amplitude over time. The plot of motion over time is indicative of particular forms of coagulation disorders. The rotating motion of the BioMEMS device is induced externally using a magnetic field. The rotation induced is not limited to a magnetic field but could be direct mechanical or electrostatic inducer of the rotation. The magnetic actuation is provided by a motor, servo or similar device that turns a magnet. The motor can be controlled mechanically or electronically, by the iPhone for example, to provide a specific pattern. In one case the pattern is 4° 45′ in 5 seconds. There can be a large range of patterns, dependent on application. In one case the profile is measured for 30 to 60 minutes, however time may vary depending on application.
The invention is useful to small hospitals, clinics, ambulances, home and individuals and is useful for paramedics and EMT's.
Use of a mobile device, such as an iPhone and the new device has been demonstrated to show coagulation over time in the form of a coagulation profile. The invention makes the testing simpler by use of a cartridge and provides a method of having a large number of sequential tests to monitor a patient from POI to the emergency room (ER), operating room and recovery. The overall system and the cartridge are very small. The use of cartridges in the invention simplifies the process as compared to conventional techniques. Being small and portable there is potential provided by the invention for a large number of parallel or serial devices operating simultaneously.
The system comprises a handheld medical analyzer platform, which works with different disposable application cartridges to perform a variety of interrogations on specimen samples. One application includes attaching a biological microelectromechanical systems (BioMEMS) cartridge that generates blood coagulation profiles indicative of particular forms of coagulation disorders. The device makes coagulopathy testing simpler for small hospitals, clinics, ambulances, remote locations and individuals by use of a cartridge and permits for a larger number of parallel or serial devices operating simultaneously. One insertion of a cartridge actuates an oscillating circular motion to generate a blood coagulation profile based on a change in rotational motion as blood coagulates in a sample. Change in rotational motion is analyzed through a video camera such as in a smartphone and is plotted to show an amplitude over time. Actuation of the BioMEMS can be achieved by magnetic actuation of a motor controlled by an iPhone or a smart phone to provide a specific rotational pattern.
The present invention has a cartridge configured for inserting in a receiver to measure rate of coagulation of a liquid. A well in the cartridge is configured to receive and hold the liquid. A disk is configured for relatively rotating in the liquid within the well and is rotatable in the well, the disk or the well being relatively rotatable as the liquid coagulates.
The cartridge is configured to be inserted into a reader. The cartridge is wider than thick and longer than wide and is configured for longitudinally inserting in the receiver. The disk has a thin thickness relative to a wide diameter for fitting in the well, and the disk has a downward extending central spindle for contacting a bottom of the well. The disk has a magnetic portion for turning with a contactless magnetic coupling.
The cartridge further has a slidable lid. The disk is attached to the lid, and the cartridge has an abutment configured for abutting and detaching the disk from the lid and thereby dropping the disk into the well upon sliding the lid with respect to a remainder of the cartridge. The cartridge is configured to receive and hold blood in the well.
The present invention has a cartridge configured for inserting in a receiver and receiving a fluid sample. The cartridge has a platform. A retainer is connected to the platform for retaining the cartridge in the reader. A well in the platform holds a blood sample. A channel is embedded into the cartridge for injecting the fluid sample into the well. In one iteration the sample is injected into the channel after insertion of the cartridge into the receiver and the cartridge being brought to the desired temperature. At this point the lid is horizontally engaged and the disk is abutted to the abutment, dropping the disk into the filled well. A disk is configured to be positioned and supported in the well and to be turnable within the well. The disk further has a permeable part for magnetic coupling to a reciprocally turning magnet.
The platform has a portion configured for extending outward from the reader. The guide has a passageway in the platform connected between the well and an entrance port on the portion of the platform extending outward from the platform. The passageway slopes downward and inward from the entrance to the well. Upward and inward facing channels are situated on opposite side edges of the platform. A lid is slidable within the channels for covering the well.
The platform is constructed in two parts, an outer part and an inner part. The outer part has the portion extending out of the receiver, the guide channels for the lid and the retainer. The inner part has the well. The lid projects forward into the receiver from the cartridge when the cartridge is placed in the receiver. The disk is temporarily attached to the lid, and the platform has an abutment which contacts the disk and detaches the disk from the lid when the lid moves onward over the platform and the disk is aligned with the well.
A method of analyzing coagulation of a liquid provides a cartridge with a platform. A well is provided in the platform. A magnet is provided in the disk. A disk turns in the well, supplying the liquid in the well and reciprocally turning the disk within the liquid in the well with a magnetic coupling.
A retainer on the platform retains the platform in a receiver. An extended portion of the platform provides an entrance port for the liquid on the extended portion, and a passageway for the liquid from the entrance to the well.
The platform has upward and inward facing channels. A lid extends between and slides in the channels.
The disk is attached to the lid. The lid is extended from the platform. The lid is slid on the platform. An abutment on the platform encounters the disk on the lid, dislodging the disk from the lid, and dropping the disk into the well as the lid is slid on the platform.
The platform is inserted with the extended lid into the receiver. The liquid is injected into the entrance. The liquid flows through the passageway into the well. A pusher slides the lid and the disk drops into the well. The disk is reciprocally rotated with a non-contact magnetic coupling. Later, the cartridge is withdrawn with the platform, the disk in the well and the lid on the platform and discarding the cartridge, the platform, disk and lid.
These and further and other objects and features of the invention are apparent in the disclosure, which includes the above and ongoing written specification, with the claims and the drawings.
The invention provides a handheld medical analyzer platform and biological microelectromechanical systems (BioMEMS) cartridges. This combined system uses microfluidics, optics, a mobile device (e.g. a smartphone or tablet) and video analysis software to create a handheld analyzer that produces data used in medical and biological diagnostics. In this embodiment two primary components are the handheld medical analyzer and the coagulation profile cartridge. The combination of the handheld analyzer and coagulation profile cartridge provide results equal to bench top systems used in hospitals, such as TEG and ROTEM. The handheld medical analyzer is a platform that is capable of analyzing a variety of cartridges. However the coagulation profile cartridge is specific to coagulopathy applications only. Although the cartridges are intended to be disposable, they also can be implemented in a permanent fashion when cleaned properly and constructed of the proper material. Combined, the handheld medical analyzer and coagulation profile cartridge produce a coagulation profile which is displayed and stored on the analyzer. In this embodiment of the invention, the cartridge provides data used in diagnosing different forms of coagulopathy.
Although the combination of the handheld analyzer and coagulation profile cartridge is one part of the invention, the handheld analyzer is not limited to analyzing this specific cartridge.
Other similar embodiments include profiling the coagulation of Limulus amebocyte lysate (LAL). In this case the extent of LAL coagulation would be representative of the presence of gram negative bacteria, since the LAL reacts with bacterial endotoxin or lipopolysaccharide (LPS).
A similar cartridge would also apply to other assays that detect a physical change in the sample, such a viscosity, elasticity or viscoelasticity. Examples of these embodiments may include saliva, cervical mucus or other body fluids.
Furthermore the handheld analyzer is also capable of using the same basic configuration to analyze a great many cartridges. These embodiments would also capture data using the video camera and interrogated using the CPU and GPU running proprietary software. These cartridges include, but are not limited to Pa02, pH and blood type.
Likewise similar use of a smartphone for cartridge analysis is not limited to video input, but also could use many other sensors on the smartphone, including direct electrical signals, wireless signals, manometer, accelerometer, gyroscopes and compass. This includes combinations of the different methods of obtaining direct sensor information and indirect supplementary sensor information. An example of this would be using the combined system to provide a coagulation profile, while using the smartphone, wireless communication, accelerometers, gyroscopes, GPS, etc. to provide stabilization in rough environments such as a helicopter which is in motion and vibrating. These subsystems could also be used to send the coagulation profile, GPS coordinates to the ER providing an estimated time of arrival (ETA) and allowing for preparation of blood products, etc., in advanced for the patient's arrival.
A primary embodiment of the combined inventions is shown in
The coagulation profile cartridge 12 is interrogated using the compact microscope 8 and video camera 11.
The loading protocol for the simplest embodiment of the combined system is: place blood 15 into well 14 on cartridge 12 and load the cartridge into analysis slot 7, also shown in
Upon loading the cartridge the measurement begins as the disk is actuated, as shown in
In the embodiment the degree to which the motion is decoupled is representative of the displayed 2 profile 3, as shown in
The alpha numeric displays:
R: 31.329 sec
K: 156.846 sec
a: 2.834 deg/sec
MA: 34.482 mm
The motion of the disc is captured by tracking two points overtime.
The detailed translation of the device motion is shown in
A second embodiment of the BioMEMS device is shown in
A third embodiment of a coagulation profiling BioMEMS device is shown
The BioMEMS embodiments shown are not all of the possible variations. For instance, one embodiment could use disc fixed to the center of the well and actuate a ferrous ring in the well. These variation of the described embodiments are apparent to one skilled in the art.
The measurement provided by the invention is impervious to motion. Due to the extremely small dimensions of the BioMEMS device, compared to the conventional size of TEG and ROTEM, the measurement is highly impervious to motion. The small mass of the device and small volume residing in the well present less inertia when external motion is applied. The ability to produce a noise-free measurement in the presence of motion is further enhanced by the magnetic coupling, which fixes the disc and the well in the magnetic field.
A prototype of the invention has provided concept validation. The image shown in
While the invention has been described with reference to specific embodiments, modifications and variations of the invention may be constructed without departing from the scope of the invention, which is defined in the following claims.
This application claims the benefit as a continuation of U.S. patent application Ser. No. 14/526,034 filed on Oct. 28, 2014, which in turn claims the benefit as a nonprovisional application of U.S. Provisional Application No. 61/896,405 filed Oct. 28, 2013, each of the foregoing applications of which are hereby incorporated by reference in its entirety as if fully set forth herein.
This invention was made with government support under Contract No. W81WH-11-C-0055 awarded by the U.S. Army Medical Research Acquisition Activity. The government has certain rights in the invention.
Number | Name | Date | Kind |
---|---|---|---|
3053078 | Jewett | Sep 1962 | A |
3520659 | Steinberg | Jul 1970 | A |
3650698 | Adler | Mar 1972 | A |
3695842 | Mintz | Oct 1972 | A |
3704099 | Sanz | Nov 1972 | A |
3836333 | Mintz | Sep 1974 | A |
3861197 | Adler | Jan 1975 | A |
3875791 | Fitzgerald | Apr 1975 | A |
4045999 | Palmer | Sep 1977 | A |
4081242 | Girolami | Mar 1978 | A |
4148216 | Do | Apr 1979 | A |
4193293 | Cavallari | Mar 1980 | A |
4317363 | Shen | Mar 1982 | A |
4328701 | Mau-Tung | May 1982 | A |
4334424 | Kepes | Jun 1982 | A |
4341111 | Husar | Jul 1982 | A |
4706207 | Hennessy et al. | Nov 1987 | A |
4918984 | Martinoli | Apr 1990 | A |
4964728 | Kloth | Oct 1990 | A |
5016469 | Henderson | May 1991 | A |
5071247 | Markosian | Dec 1991 | A |
5110727 | Oberhardt | May 1992 | A |
5138872 | Henderson | Aug 1992 | A |
5154082 | Mintz | Oct 1992 | A |
5163317 | Ono | Nov 1992 | A |
5223227 | Zuckerman | Jun 1993 | A |
5350676 | Oberhardt | Sep 1994 | A |
5523238 | Varon | Jun 1996 | A |
5629209 | Braun, Sr. | May 1997 | A |
5777215 | Calatzis | Jul 1998 | A |
5789664 | Neel | Aug 1998 | A |
6016712 | Warden | Jan 2000 | A |
6103196 | Yassinzadeh | Aug 2000 | A |
6136271 | Lorincz | Oct 2000 | A |
6165795 | Mize | Dec 2000 | A |
6225126 | Cohen | May 2001 | B1 |
6573104 | Carr, Jr. | Jun 2003 | B2 |
6586259 | Mahan | Jul 2003 | B1 |
6591663 | Murray | Jul 2003 | B1 |
6591664 | Litton | Jul 2003 | B2 |
6613573 | Cohen | Sep 2003 | B1 |
6767511 | Rousseau | Jul 2004 | B1 |
6898532 | Toh | May 2005 | B1 |
6989272 | Savion | Jan 2006 | B1 |
7179652 | Cohen | Feb 2007 | B2 |
7182913 | Cohen | Feb 2007 | B2 |
7211438 | Toh | May 2007 | B2 |
7235213 | Mpock | Jun 2007 | B2 |
7262059 | Zheng | Aug 2007 | B2 |
7399637 | Wright | Jul 2008 | B2 |
7422905 | Clague | Sep 2008 | B2 |
7439069 | Nippoldt | Oct 2008 | B2 |
7524670 | Cohen | Apr 2009 | B2 |
7732213 | Cohen | Jun 2010 | B2 |
7754489 | Cohen | Jul 2010 | B2 |
8076144 | Cohen | Dec 2011 | B2 |
8211381 | Ricci | Jul 2012 | B2 |
8322195 | Glauner | Dec 2012 | B2 |
8365582 | Sakai | Feb 2013 | B2 |
8383045 | Schubert | Feb 2013 | B2 |
8425840 | Hosokawa | Apr 2013 | B2 |
8448499 | Schubert | May 2013 | B2 |
8450078 | Dennis | May 2013 | B2 |
8795210 | Talish | Aug 2014 | B2 |
8877710 | Johansson | Nov 2014 | B2 |
9046512 | Djennati | Jun 2015 | B2 |
9063161 | Dennis | Jun 2015 | B2 |
10184872 | Sakai | Jan 2019 | B2 |
20010022948 | Tuunanen | Sep 2001 | A1 |
20020124634 | Litton | Sep 2002 | A1 |
20020168294 | Carr, Jr. | Nov 2002 | A1 |
20030064505 | Harttig | Apr 2003 | A1 |
20030069702 | Cohen | Apr 2003 | A1 |
20030073244 | Cohen | Apr 2003 | A1 |
20030180824 | Mpock | Sep 2003 | A1 |
20030199428 | Carr, Jr. | Oct 2003 | A1 |
20040131500 | Chow | Jul 2004 | A1 |
20040161855 | Kvasnik et al. | Aug 2004 | A1 |
20040203163 | Cohen | Oct 2004 | A1 |
20040224419 | Zheng | Nov 2004 | A1 |
20050180886 | Bote Bote | Aug 2005 | A1 |
20050233460 | Clague | Oct 2005 | A1 |
20050233466 | Wright | Oct 2005 | A1 |
20050255601 | Nippoldt | Nov 2005 | A1 |
20060034734 | Schubert | Feb 2006 | A1 |
20070059840 | Cohen | Mar 2007 | A1 |
20070158246 | Davies | Jul 2007 | A1 |
20070184508 | Cohen | Aug 2007 | A1 |
20070291345 | Kumar et al. | Dec 2007 | A1 |
20080011107 | Leventhal et al. | Jan 2008 | A1 |
20080015477 | Talish | Jan 2008 | A1 |
20080038828 | Cohen | Feb 2008 | A1 |
20080206880 | Clague | Aug 2008 | A9 |
20080233554 | Sehgal | Sep 2008 | A1 |
20080261261 | Grimes | Oct 2008 | A1 |
20090198120 | Gurbel | Aug 2009 | A1 |
20090304547 | Werner | Dec 2009 | A1 |
20100139375 | Johns | Jun 2010 | A1 |
20100154520 | Schubert | Jun 2010 | A1 |
20100170327 | Glauner | Jul 2010 | A1 |
20100184201 | Schubert | Jul 2010 | A1 |
20100268094 | Hasling | Oct 2010 | A1 |
20110036150 | Sakai | Feb 2011 | A1 |
20110151491 | Dennis | Jun 2011 | A1 |
20110223663 | Sehgal | Sep 2011 | A1 |
20110268732 | Johansson | Nov 2011 | A1 |
20120028342 | Ismagilov | Feb 2012 | A1 |
20120111097 | Sierro | May 2012 | A1 |
20120294767 | Viola | Nov 2012 | A1 |
20130195722 | Mitchell | Aug 2013 | A1 |
20130267017 | Dennis | Oct 2013 | A1 |
20140020475 | Inoue | Jan 2014 | A1 |
20140047903 | Sakai | Feb 2014 | A1 |
20140273249 | Yuan | Sep 2014 | A1 |
20150024473 | Wu | Jan 2015 | A1 |
20150118691 | De Laat | Apr 2015 | A1 |
20150226725 | Gill | Aug 2015 | A1 |
20150253343 | Pearce | Sep 2015 | A1 |
20150301018 | Dayel et al. | Oct 2015 | A1 |
20150305681 | Nadkarni | Oct 2015 | A1 |
Number | Date | Country |
---|---|---|
0 525 273 | Oct 1996 | EP |
01-263533 | Oct 1989 | JP |
WO 2013067536 | May 2013 | WO |
WO 2020023726 | Jan 2020 | WO |
Entry |
---|
Muller, O. et al, Macromolecues 1991,24, 3111-3120. |
Gasull, A. et al, IEEE 1992, 1948-1949. |
Ziemann, F. et al, Biophysical Journal 1994, 66, 2210-2216. |
Crocker, J. C. et al, Journal of Colloid and Interface Science 1996, 179, 298-310. |
Shore-Lesserson, L. et al, Anesthesia & Analgesia 1999, 88, 312-319. |
Smith, Z. J. et al, PLOS One 2011, 11, paper e17150, 11 pages. |
Hortschitz, W. et al, IEEE Sensors Journal 2011, 11, 2805-2812. |
Castro-Palacio, J. C. et al, American Journal of Physics 2013, 81, 472-475. |
StirBars.com, “Stir Bar Price List” accessed Apr. 14, 2015 in 13 pages. |
“GPU-accelerated video processing on Mac and iOS”, Sunset Lake Software, www.sunsetlakessoftware.com/2010/10/22/gpu-accwelerated-video-processing-mak-and-iOS; Oct. 22, 2010. |
Number | Date | Country | |
---|---|---|---|
61896405 | Oct 2013 | US |
Number | Date | Country | |
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Parent | 14526034 | Oct 2014 | US |
Child | 15607105 | US |