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

基本信息

批准号：
9981298
负责人：
Ellis Meng
金额：
$ 17.81万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9981298
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 Family suidae 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 Thrombosis 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 pre-clinical preservation prevent prototype reconstruction response sensor side effect standard of care

项目摘要

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.

患有一处或两处心室缺陷的新生儿患者依赖于改良的 Blalock-Taussig 分流术（mBTS）以建立适当的全身血流，同时该手术挽救了许多新生儿的生命。对于紫绀型心脏缺陷，由于血栓和/或内膜堆积而导致 mBTS 阻塞导致高死亡率和发病率的问题此外，护理费用也是最重要的。对于任何外科手术来说都是昂贵的。分流阻塞可因肺循环不足而导致缺氧和猝死。分流闭塞可能是突然的，并且没有足够的警告来防止患者病情迅速恶化或者，分流阻塞也可能逐渐发生，但即使在这种情况下，狭窄也会逐渐发生。当需要紧急干预时，分流管腔的损坏可能会导致类似的不良副作用。尽管采取了非常积极的复苏措施，但通常很难挽救分流阻塞的婴儿。再通可以纠正分流阻塞，影像学方法不足以解决阻塞问题。因此，及早发现分流管阻塞对于避免这种情况至关重要。紧急干预和可预防的生命损失的需要。该提案解决了对能够检测重要信息的微型传感器的未满足的临床需求。通过 mBTS 的血流量变化需要开发适合使用的流量传感器。分流术带来了一些独特的挑战，但如果成功，可以通过以下方式降低发病率和死亡率及时、知情的再通。系统方法包括首先在非接触式平台上展示概念验证流量传感，然后开发适合体内使用的分流传感器系统，然后是最终的在猪模型中演示有线传感器。这项工作的预期成果是演示。适合与分流器一起使用的非接触式流量传感器，可实现作为 mBTS 的传感器分流系统。成功的演示将为开发无线遥测技术铺平道路，以实现无线用于慢性动物研究的 mBTS 非接触式传感方法也可应用于其他合成。该提案将建立对于实现血管移植或引流分流至关重要的概念验证。用于家庭护理中定期监测的无线询问流量传感器系统的长期目标能够进行早期预警以推动拯救生命的干预措施的设置。