Monitoring systems and quantitative measurement of biomolecules for the management of Trauma
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Monitoring systems and quantitative measurement of biomolecules for the management of Trauma Christian N. Kotanen & Anthony Guiseppi-Elie
Published online: 15 March 2013 # Springer Science+Business Media New York 2013
Abstract 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 C. N. Kotanen : A. Guiseppi-Elie (*) Center for Bioelectronics, Biosensors and Biochips (C3B), Clemson University Advanced Materials Center, 100 Technology Drive, Anderson, SC 29625, USA e-mail: [email protected] C. N. Kotanen e-mail: [email protected] A. Guiseppi-Elie Department of Chemical and Biomolecular Engineering, Clemson University, 132 Earle Hall, Clemson, SC 29634, USA C. N. Kotanen : A. Guiseppi-Elie Department of Bioengineering, Clemson University, 132 Earle Hall, Clemson, SC 29634, USA A. Guiseppi-Elie Department of Electrical and Computer Engineering, Clemson University, 132 Earle Hall, Clemson, SC 29634, USA A. Guiseppi-Elie ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA 23219, USA
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. Keywords Monitoring . Shock . Trauma . Hemorrhage . Diagnostics
1 Introduction Hemorrhage is a primary complication of trauma as seen on battlefields, in emergency departments, operating rooms, and intensive care units (Veliz et al. 2010; Gutierrez et al. 2004). Available mortality data shows that, in 2006, unintentional injuries were the leading cause of death in individuals of 1–44 years of age and the 5th over-all leading cause of death for all age groups in the United States (NCHS 2009). Also, in 2006, for every trauma induced death, there were eleven times as many hospitalizations
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