TY - JOUR
T1 - Monitoring systems and quantitative measurement of biomolecules for the management of Trauma
AU - Kotanen, Christian N.
AU - Guiseppi-Elie, Anthony
N1 - Funding Information:
Acknowledgments This work was supported by the US Department of Defense (DoDPRMRP) grant PR023081/DAMD17-03-1-0172, by the Consortium of the Clemson University Center for Bioelectronics, Biosensors and Biochips (C3B) and by ABTECH Scientific, Inc.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2013/6
Y1 - 2013/6
N2 - Continued high morbidity and complications due to trauma related hemorrhage underscores the fact that our understanding of the detailed molecular events of trauma are inadequate to bring life-saving changes to practice. The current state of efficacy and advances in biomedical microdevice technology for trauma diagnostics concerning hemorrhage and hemorrhagic shock was considered with respect to vital signs and metabolic biomarkers. Tachycardia and hypotension are markers of hemorrhagic shock in decompensated trauma patients. Base deficit has been predicative of injury severity at hospital admission. Tissue oxygen saturation has been predicative of onset of multiple organ dysfunction syndrome. Blood potassium levels increase with onset of hemorrhagic shock. Lactate is a surrogate for tissue hypoxia and its clearance predicts mortality. Triage glucose measurements have been shown to be specific in predicting major injuries. No vital sign has yet to be proven effective as an independent predictor of trauma severity. Point of care (POC) devices allow for rapid results, easy sample preparation and processing, small sample volumes, small footprint, multifunctional analysis, and low cost. Advances in the field of in-vivo biosensors has provided a much needed platform by which trauma related metabolites can be monitored easily, rapidly and continuously. Multi-analyte monitoring biosensors have the potential to explore areas still undiscovered in the realm of trauma physiology.
AB - Continued high morbidity and complications due to trauma related hemorrhage underscores the fact that our understanding of the detailed molecular events of trauma are inadequate to bring life-saving changes to practice. The current state of efficacy and advances in biomedical microdevice technology for trauma diagnostics concerning hemorrhage and hemorrhagic shock was considered with respect to vital signs and metabolic biomarkers. Tachycardia and hypotension are markers of hemorrhagic shock in decompensated trauma patients. Base deficit has been predicative of injury severity at hospital admission. Tissue oxygen saturation has been predicative of onset of multiple organ dysfunction syndrome. Blood potassium levels increase with onset of hemorrhagic shock. Lactate is a surrogate for tissue hypoxia and its clearance predicts mortality. Triage glucose measurements have been shown to be specific in predicting major injuries. No vital sign has yet to be proven effective as an independent predictor of trauma severity. Point of care (POC) devices allow for rapid results, easy sample preparation and processing, small sample volumes, small footprint, multifunctional analysis, and low cost. Advances in the field of in-vivo biosensors has provided a much needed platform by which trauma related metabolites can be monitored easily, rapidly and continuously. Multi-analyte monitoring biosensors have the potential to explore areas still undiscovered in the realm of trauma physiology.
KW - Diagnostics
KW - Hemorrhage
KW - Monitoring
KW - Shock
KW - Trauma
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U2 - 10.1007/s10544-013-9756-x
DO - 10.1007/s10544-013-9756-x
M3 - Article
C2 - 23494594
AN - SCOPUS:84877747858
VL - 15
SP - 561
EP - 577
JO - Biomedical Microdevices
JF - Biomedical Microdevices
SN - 1387-2176
IS - 3
ER -