RESUMEN
This work describes a fully-integrated portable microfluidic analysis system for real-time monitoring of dynamic changes in glucose and lactate occurring in the brain as a result of cardiac arrest and resuscitation. Brain metabolites are sampled using FDA-approved microdialysis probes and coupled to a high-temporal resolution 3D printed microfluidic chip housing glucose and lactate biosensors. The microfluidic biosensors are integrated with a wireless 2-channel potentiostat forming a compact analysis system that is ideal for use in a crowded operating theatre. Data are transmitted to a custom-written app running on a tablet for real-time visualisation of metabolic trends. In a proof-of-concept porcine model of cardiac arrest, the integrated analysis system proved reliable in a challenging environment resembling a clinical setting; noise levels were found to be comparable with those seen in the lab and were not affected by major clinical interventions such as defibrillation of the heart. Using this system, we were able, for the first time, to measure changes in brain glucose and lactate levels caused by cardiac arrest and resuscitation; the system was sensitive to clinical interventions such as infusion of adrenaline. Trends suggest that cardiopulmonary resuscitation alone does not meet the high energy demands of the brain as metabolite levels only return to their values preceding cardiac arrest upon return of spontaneous circulation.
Asunto(s)
Encéfalo/metabolismo , Reanimación Cardiopulmonar , Glucosa/análisis , Paro Cardíaco/metabolismo , Ácido Láctico/análisis , Aerococcus/enzimología , Animales , Aspergillus niger/enzimología , Biomarcadores/análisis , Biomarcadores/química , Técnicas Biosensibles/métodos , Isquemia Encefálica/metabolismo , Femenino , Glucosa/química , Glucosa Oxidasa/química , Paro Cardíaco/terapia , Ácido Láctico/química , Microdiálisis , Técnicas Analíticas Microfluídicas/métodos , Oxigenasas de Función Mixta/química , Monitorización Neurofisiológica/métodos , Prueba de Estudio Conceptual , PorcinosRESUMEN
Are current diversity, equity, and inclusion initiatives addressing systemic issues? This article highlights the progress thus far and emphasizes the systemic and cultural shifts needed to support and retain historically excluded scientists.
Asunto(s)
Diversidad CulturalRESUMEN
This paper presents the design, optimisation and fabrication of a mechanically robust 3D printed microfluidic device for the high time resolution online analysis of biomarkers in a microdialysate stream at microlitre per minute flow rates. The device consists of a microfluidic channel with secure low volume connections that easily integrates electrochemical biosensors for biomarkers such as glutamate, glucose and lactate. The optimisation process of the microfluidic channel fabrication, including for different types of 3D printer, is explained and the resulting improvement in sensor response time is quantified. The time resolution of the device is characterised by recording short lactate concentration pulses. The device is employed to record simultaneous glutamate, glucose and lactate concentration changes simulating the physiological response to spreading depolarisation events in cerebrospinal fluid dialysate. As a proof-of-concept study, the device is then used in the intensive care unit for online monitoring of a brain injury patient, demonstrating its capabilities for clinical monitoring.