Dynamic Light Scattering:a Novel, Promising Technique For Continuous, Real-time Assessment Of Coagulation Status In Pediatric Cardiac Surgery
William M. DeCampli, M.D., Ph.D1, Rafael Guzman-Sepulveda, Ph.D2, M. Batarseh, B.S.2, R. Wu, B.S.2, Andrew Pollizzi, B.S.2, Aristide Dogariu, Ph.D2.
1Orlando Health/Arnold Palmer Hospital for Children, Orlando, FL, USA, 2University of Central Florida, Orlando, FL, USA.
Objective: Coagulation tests currently require repeated blood draws and time to process. In pediatric cardiac surgery, coagulation status may change rapidly both during and after cardiopulmonary bypass (CPB). We investigated an approach that may provide coagulation assessment continuously.
Method: We developed instrumentation to measure changes in blood viscoelasticity based on the principle of spatiotemporal coherence-gated dynamic light scattering. We placed a 120 μm optical fiber in the side port of the arterial line in 30 infants undergoing cardiac surgery with CPB. Incident light (λ= 670 nm) backscattered off of red blood cells (RBCs) was combined with a received reference signal. The time varying interference pattern due to the random thermal motion of RBCs (influenced by plasma viscoelastic properties (VE)) was analyzed in the frequency domain. Software calculated the logarithmic tangent (“logslope”) of the power spectral density curve averaged over the frequency range 250-750 Hz at four time points before, during and after CPB. Logslope is directly related to VE. We calculated Pearson correlation (R) between the incremental time changes (delta) in logslope and those of activated clotting time (ACT).
Results: (Fig) Delta logslope was highly correlated with delta ACT (p < 0.0001).
Conclusion: Changes in a continuously measurable index of blood viscoelasticity closely track changes in ACT. This index may allow more timely control of both anticoagulation and hemostasis during and after surgery.
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