Identifying life threatening bleeding using iCoaglab

Increased risk of organ failure and death in hospitalized patients may occur due to Delayed identification of coagulopathy and bleeding. Improved outcomes for patients can be provided by Timely and accurate identification of impaired coagulation at the point-of-care. This can identify the bleeding risk and guide resuscitation as well.

A team led by investigators at Massachusetts General Hospital has developed a novel, inexpensive and portable device that can quickly and accurately measure the ability of blood to properly clot (or coagulate).

 The novel and innovative device called iCoaglab has developed which has the capability to identify patients with elevated risk for bleeding. The device is extremely effective in identifying bleeding risks and preventing hemorrhage, a study published in the journal Thrombosis and Haemostasis, 2020, has found

iCoagLab is a novel and innovative device which is used for comprehensive whole blood coagulation profiling. 

In the study, the researchers tested the accuracy of a novel optical coagulation sensing approach and investigated its diagnostic accuracy in identifying patients at elevated bleeding risk.

Nearly 270 Whole blood samples collected from patients undergoing conventional coagulation testing were measured using the iCoagLab device. Re calcified and kaolin-activated blood samples were loaded in disposable cartridges. Using these samples, time-varying intensity fluctuation of laser speckle patterns were measured to quantify the clot viscoelastic modulus during coagulation.

Coagulation parameters including the reaction time (R), clot progression time (K), clot progression rate (α), and maximum clot strength (MA) were derived from clot viscoelasticity traces. These were compared with mechanical thromboelastography (TEG).

From the study the researchers found the following:

• In all patients, a good correlation between iCoagLab- and TEG-derived parameters was observed (p < 0.001).

• Multivariate analysis showed that iCoagLab-derived parameters identified bleeding risk with sensitivity (94%) identical to, and diagnostic accuracy (89%) higher than TEG (87%).

• The diagnostic specificity of iCoagLab (77%) was significantly higher than TEG (69%).

 The researchers concluded that By rapidly and comprehensively permitting blood coagulation profiling the iCoagLab innovation is likely to advance the capability to identify patients with elevated risk for bleeding, with the ultimate goal of preventing life-threatening hemorrhage.

"Clinicians in the operating room or the ICU often walk a thin line to maintain the delicate balance between bleeding and coagulation," said senior author Seemantini K. Nadkarni, PhD, an associate professor at Harvard Medical School and director of the Nadkarni Laboratory for Optical Micromechanics and Imaging at the Wellman Center for Photomedicine at Mass General.

"The iCoagLab innovation will likely advance clinical capability to rapidly identify patients with defective clotting at the point-of-care, assess risk of hemorrhage, and tailor treatments based on individual coagulation deficits to help prevent life-threatening bleeding in patients."

To further read about the study, click the following link:

http://dx.doi.org/10.1055/s-0040-1712956