Point of care technologies for sepsis diagnosis and treatment

Abstract

Sepsis is a rapidly progressing, life threatening immune response triggered by infection that affects millions worldwide each year. Current clinical diagnosis relies on broad physiological parameters and time consuming lab-based cell culture. If proper treatment is not provided, cases of sepsis can drastically increase in severity over the course of a few hours. Development of new point of care tools for sepsis has the potential to improve diagnostic speed and accuracy, leading to prompt administration of appropriate therapeutics, thereby reducing healthcare costs and improving patient outcomes. In this review we examine developing and commercially available technologies to assess the feasibility of rapid, accurate sepsis diagnosis, with emphasis on point of care.

Figure 1.

A) Recommended use of POC sepsis chip in clinical care. Adapted with permission from Ref. . B) Categories of whole blood sepsis diagnostics are listed on the top and ordered by relative speed and accuracy depicted as gradients on the bottom.

Figure 2.

Example smart phone enabled POC interleukin detection device. Reproduced with permission from Ref. .

Figure 3.

A) Microfluidic CD64 expression quantification device with lysing and quenching zones for erythrocyte removal. False-colored fluorescent image of CD64+ cells captured on anti-CD64 coated pillars in the CD64 cell depletion zone. Reproduced with permission from Ref. .B) Microfluidic assay for spontaneous neutrophil motility from a drop of blood. Reproduced with permission from Ref. .

Figure 4.

A) Example pathogen removal apparatus. Adapted with permission from Ref. . B) Magnetic bead capture of S. aureus and E. coli. Reproduced with permission from Ref. . C)Magnetic opsonin and biospleen device for pathogen removal and blood cleansing. Reproduced with permission from Ref. . D-E) Acoustic separation of bacteria and blood cells. Reproduced with permission from Ref. .