Flexible bioelectronic sensors for non-contact detection of obstruction in pediatric vascular shunts

用于非接触式检测儿科血管分流阻塞的柔性生物电子传感器

• 批准号: 10171845
• 负责人: Ellis Meng
• 金额: $ 29.88万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10171845
• 关键词: Acute; Address; Animals; Arteries; Blood; Blood Substitutes; Blood Vessels; Blood flow; Caliber; Cardiovascular system; Catheters; Child; Childhood; Chronic; Clinical; Clinical Trials; Common Ventricle; Computer software; Coupled; Coupling; Critical Care; Data; Defect; Detection; Deterioration; Development; Drainage procedure; Early Diagnosis; Electric Capacitance; Electrodes; Electronics; Emergency Situation; Encapsulated; Ensure; Failure; Functional disorder; Future; Goals; Heart; Heart Abnormalities; Heart Ventricle; Hypoxia; Implant; Industrialization; Infant; Intervention; Lead; Life; Liquid substance; Literature; Location; Lung; Measurement; Measures; Methods; Modeling; Modification; Monitor; Morbidity - disease rate; Newborn Infant; Obstruction; Operative Surgical Procedures; Outcome; Patients; Pediatric cardiology; Performance; Perfusion; Periodicity; Physiology; Preparation; Procedures; Pulmonary Circulation; Pulmonary artery structure; Pulsatile Flow; Reporting; Research; Resistance; Resolution; Resuscitation; Risk; Saline; Shunt Device; Source; Staging; Sudden Death; Surgical sutures; System; Technology; Telemetry; Thrombus; Time; Vascular Graft; Width; Wireless Technology; Work; base; care costs; data acquisition; design; flexibility; hazard; high reward; high risk; imaging modality; in vivo; in vivo evaluation; instrumentation; invention; mortality; neonatal patient; neonate; palliation; palliative; patient home care; porcine model; pre-clinical; preservation; prevent; prototype; reconstruction; response; sensor; side effect; standard of care; thrombotic complications

Neonatal patients having one or two ventricle defects are dependent on the modified Blalock-Taussig shunt (mBTS) to establish proper systemic blood flow. While the procedure has saved many newborns with cyanotic heart defects, the obstruction of mBTS due to either thrombus and/or intimal build up has been problematic leading to high mortality and morbidity. In addition, the cost of care is among the most expensive for any surgical procedure. Shunt obstruction can lead to hypoxia and sudden death due to insufficient pulmonary circulation. Shunt occlusion can be sudden and without enough warning to prevent rapid deterioration of the patient’s condition. Alternatively, shunt obstruction can also occur gradually. But even in this case, the narrowing of the shunt lumen may result in similar adverse side effects. When emergency intervention is required, despite very aggressive resuscitation, it is frequently difficult to save infants with shunt obstruction. Recanalization can correct shunt obstruction. Imaging methods are inadequate to resolve obstruction within these 3-5 mm diameter shunts. Therefore, early detection of shunt obstruction is critical to avoid the need for emergency intervention and preventable loss of life. This proposal addresses the unmet clinical need for miniature sensors that can detect significant changes in blood flow through mBTS necessitating intervention. Developing flow sensors suitable for use with shunts poses several unique challenges but if successful, can reduce morbidity and mortality through timely, informed recanalization. The systematic approach involves first demonstrating proof-of-concept at the benchtop of non-contact flow sensing, followed by developing shunt sensor systems suitable for in vivo use, and then a final demonstration of wired sensors in a pig model. The expected outcome of this work is the demonstration of a non-contact flow sensor suitable for use with shunts to enable a sensor-shunt system as mBTS. The successful demonstration will pave the way for development of a wireless telemetry to enable a wireless mBTS for chronic animal studies. The non-contact sensing method also can be applied to other synthetic vascular grafts or drainage shunts. This proposal will establish proof-of-concept that is critical to achieve the long term goal of a wirelessly interrogated flow sensor system for periodic monitoring in a home care setting that enables early warning to drive intervention that saves lives.

具有一个或两个心室缺陷的新生儿患者取决于改良的黑色陶斯格 分流（MBT）建立适当的全身血流。虽然该程序拯救了许多新生儿 伴有蓝心脏缺陷，由于血栓和/或内膜堆积引起的MBT反对 我们有问题导致高死亡率和发病率。此外，护理成本是最大的 任何手术程序都昂贵。 分流反对可能导致缺氧和由于肺部循环不足而导致猝死。 分流的闭塞可能会突然出现，没有足够的警告以防止对患者的快速定义 条件。在线，分流阻塞也可以逐渐发生。但是即使在这种情况下，狭窄 分流腔的腔可能会导致类似的不良副作用。当需要紧急干预时， 尽管复苏非常激进，但通常很难用分流阻塞来拯救婴儿。 重新定性可以纠正分流阻塞。成像方法不足以解决阻塞 在这3-5毫米直径的分流中。因此，早期发现分流阻塞对于避免 需要紧急干预和可预防的生命丧失。 该提案解决了可以检测到显着的微型传感器的未满足的临床需求 通过MBT的血液流动的变化必要的干预。开发适合使用的流动传感器 有分流有几个独特的挑战，但如果成功，可以通过 及时，有知情的再通信。 系统的方法涉及首先在非接触台上证明概念概念证明 流动传感器，然后开发适合体内使用的分流传感器系统，然后最终 猪模型中有线传感器的演示。这项工作的预期结果是演示 适用于分流的非接触流动传感器的组件，以使传感器分流系统为MBT。 成功的演示将为开发无线遥测的开发铺平道路，以启用无线 用于慢性动物研究的MBT。非接触敏感性方法也可以应用于其他合成 血管移植物或排水管。该建议将建立概念验证，这对于实现至关重要 无线询问的流动传感器系统的长期目标用于家庭护理中的周期性监控 设置使预警可以推动挽救生命的干预措施。