Coagulopathic bleeding in trauma and surgery increases the perioperative risk. Early dignosis of anticoagulant side-effects could avoid this risk. Rapid and accurate clot diagnosis system is important in assessment of hemodiluted blood coagulation. Routine coagulation analysis usually takes 30 to 60 minutes. Traditional ways for blood coagulation assessment includes thromboelastography and thromboelastometry (TEG/ROTEM). However, neither is ideal for assessing clot mechanical properties due to the poor sensitivity, repeatability and lack of common standardization. In this study, we develop a piezoelectric transducer optical coherence elastography (PZT-OCE) system that enables real-time measurement of viscosity in a drop of blood during coagulation process. During the blood coagulation process, the changes in viscous properties increase the attenuation coefficient. Consequently, coagulation metrics including the initial coagulation time and the clot formation rate can be developed by monitoring the attenuation coefficient in order to assess blood coagulation properties. The system compared blood coagulation metrics between samples with different concentrations of activator kaolin and hemodilution with either NaCl 0.9% or hydroxyethyl starch (HES) 6%. Higher concentration of activator kaolin resulted in a shorter initial coagulation time, and HES 6% caused a more pronounced dilutional hypocoagulation than NaCl 0.9%. The results show that PZT-OCE is sensitive to coagulation abnormalities and able to characterize blood coagulation status based on viscosity-related measurements, which can be used for point-of-care testing for diagnosis of coagulation disorders and monitoring of therapies.
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