An optofluidic point-of-care device for quantitative investigation of erythrocyte aggregation during coagulation

Abstract

Coagulation, the process leading to clot formation with the interplay of blood constituents, is a self-regulating mechanism, requiring attentive and periodic monitoring for numerous clinical cases. Erythrocyte aggregation (EA) is a characteristic behaviour of erythrocytes forming reversible clumps especially in vitro at low shear rates. The effect of EA during coagulation is overlooked in whole blood (WB) clotting assays, and the relationship between the two mechanisms is not well understood. We present an optofluidic point-of-care device enabling quantitative investigation of EA from 50 μl WB during the coagulation process. Not only did we explain the coagulation mechanism considering EA, but we also demonstrated coagulation time measurement from optical EA analysis. The device consists of a disposable cartridge and a handheld analyzer containing a pinch valve for fluid motion and optics for transmitted light measurement. Following the sample introduction and cessation of the valve operation, the optical signal is the lowest due to shear-induced cell disaggregation. Then, the signal increases due to EA until reaching a peak, indicating blood clotting. The working principle was proven through clinical tests for prothrombin time measurement. In addition to revealing the relation between coagulation and aggregation, this device is promising for rapid WB coagulation time measurement.