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dc.contributor.authorTshikudi, Diane M
dc.contributor.authorSimandoux, Olivier
dc.contributor.authorKang, Dongkyun
dc.contributor.authorVan Cott, Elizabeth M
dc.contributor.authorAndrawes, Michael N
dc.contributor.authorYelin, Dvir
dc.contributor.authorNadkarni, Seemantini K
dc.date.accessioned2021-06-11T23:37:42Z
dc.date.available2021-06-11T23:37:42Z
dc.date.issued2021-05-10
dc.identifier.citationTshikudi, D. M., Simandoux, O., Kang, D., Van Cott, E. M., Andrawes, M. N., Yelin, D., & Nadkarni, S. K. (2021). Imaging the dynamics and microstructure of fibrin clot polymerization in cardiac surgical patients using spectrally encoded confocal microscopy. American Journal of Hematology.en_US
dc.identifier.pmid33971046
dc.identifier.doi10.1002/ajh.26217
dc.identifier.urihttp://hdl.handle.net/10150/659889
dc.description.abstractDuring cardiac surgery with cardiopulmonary bypass (CPB), altered hemostatic balance may disrupt fibrin assembly, predisposing patients to perioperative hemorrhage. We investigated the utility of a novel device termed spectrally-encoded confocal microscopy (SECM) for assessing fibrin clot polymerization following heparin and protamine administration in CPB patients. SECM is a novel, high-speed optical approach to visualize and quantify fibrin clot formation in three dimensions with high spatial resolution (1.0 μm) over a volumetric field-of-view (165 × 4000 × 36 μm). The measurement sensitivity of SECM was first determined using plasma samples from normal subjects spiked with heparin and protamine. Next, SECM was performed in plasma samples from patients on CPB to quantify the extent to which fibrin clot dynamics and microstructure were altered by CPB exposure. In spiked samples, prolonged fibrin time (4.4 ± 1.8 to 49.3 ± 16.8 min, p < 0.001) and diminished fibrin network density (0.079 ± 0.010 to 0.001 ± 0.002 A.U, p < 0.001) with increasing heparin concentration were reported by SECM. Furthermore, fibrin network density was not restored to baseline levels in protamine-treated samples. In CPB patients, SECM reported lower fibrin network density in protaminized samples (0.055 ± 0.01 A.U. [Arbitrary units]) vs baseline values (0.066 ± 0.009 A.U.) (p = 0.03) despite comparable fibrin time (baseline = 6.0 ± 1.3, protamine = 6.4 ± 1.6 min, p = 0.5). In these patients, additional metrics including fibrin heterogeneity, length and straightness were quantified. Note, SECM revealed that following protamine administration with CPB exposure, fibrin clots were more heterogeneous (baseline = 0.11 ± 0.02 A.U, protamine = 0.08 ± 0.01 A.U, p = 0.008) with straighter fibers (baseline = 0.918 ± 0.003A.U, protamine = 0.928 ± 0.0006A.U. p < 0.001). By providing the capability to rapidly visualize and quantify fibrin clot microstructure, SECM could furnish a new approach for assessing clot stability and hemostasis in cardiac surgical patients. © 2021 Wiley Periodicals LLC.en_US
dc.language.isoenen_US
dc.publisherJohn Wiley and Sons Incen_US
dc.rights© 2021 Wiley Periodicals LLC.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en_US
dc.titleImaging the dynamics and microstructure of fibrin clot polymerization in cardiac surgical patients using spectrally encoded confocal microscopyen_US
dc.typeArticleen_US
dc.identifier.eissn1096-8652
dc.contributor.departmentCollege of Optical Sciences and Department of Biomedical Engineering, University of Arizonaen_US
dc.identifier.journalAmerican journal of hematologyen_US
dc.description.note12 month embargo; first published: 10 May 2021en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.source.journaltitleAmerican journal of hematology
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryUnited States


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