A mobile phone-based approach to detection of hemolysis

Abstract

Preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome are pregnancy-related complications with high rates of morbidity and mortality. HELLP syndrome, in particular, can be difficult to diagnose. Recent work suggests that elevated levels of free cell hemoglobin in blood plasma can, as early as the first trimester, potentially serve as a diagnostic biomarker for impending complications. We therefore developed a point-of-care mobile phone-based platform that can quickly characterize a patient's level of hemolysis by measuring the color of blood plasma. The custom hardware and software are designed to be easy to use. A sample of the whole blood (~10µL or less) is first collected into a clear capillary tube or microtube, which is then inserted into a low-cost 3D-printed sample holder attached to the phone. A 5-10min period of quiescence allows for gravitational sedimentation of the red blood cells, leaving a layer of yellowish plasma at the top of the tube. The phone camera then photographs the capillary tube and analyzes the color components of the cell-free plasma layer. The software converts these color values to a concentration of free hemoglobin, based on a built-in calibration curve, and reports the patient's hemolysis level: non-hemolyzed, slightly hemolyzed, mildly hemolyzed, frankly hemolyzed, or grossly hemolyzed.. The accuracy of the method is ~1mgdL. This phone-based point-of-care system provides the potentially life-saving advantage of a turnaround time of about 10min (versus 4+hours for conventional laboratory analytical methods) and a cost of approximately one dollar USD (assuming you have the phone and the software are already available).

Point of Care Diagnostics in Resource-Limited Settings: A Review of the Present and Future of PoC in Its Most Needed Environment

“…Many other authors agree and see great potential in microfluidics for LIC-PoC [ 52 , 53 , 54 , 55 ]. The widespread use of smartphones is considered in many publications as a possible readout-device for optical platforms, as well as an ICT-connector [ 56 , 57 , 58 , 59 , 60 ].…”

Spectral Analysis Methods Based on Background Subtraction and Curvature Calculation Used in the Detection or Quantification of Hemolysis and Icterus in Blood-derived Clinical Samples

“…For example, to detect hemolysis at the collection site without a spectrophotometer, one could photograph the plasma fractions of centrifuged collection devices using a simple point-and-shoot camera (or a cell phone camera) with the light path that includes a hybrid filter, which is composed of a narrow-band pass region and a wide-band pass region (e.g., 5-nm and 65-nm wide filters for hemolysis measurements). There have been efforts to develop technologies to detect hemolysis at the collection site such as one involving the use of color intensities of images taken with a camera [ 22 ]. The method proposed herein (Figure 18 ) would require a much smaller and simpler sample set for calibration and provide performance similar to that of a spectrophotometer, thus avoiding the need to deal with the complex, non-trivial conversion of the absorption/scattering spectra to recorded colors.…”

Novel Opportunities for Improving the Quality of Preanalytical Phase. A Glimpse to the Future?

“…Archibong et al (50) recently developed a point-of-care mobile phone-based system capable to rapidly detect the level of hemolysis in plasma. The software has been adapted to be used with a vast array of commercial mobile phones and is coupled with a 3D printed sample holder that can be attached to the smartphone.…”

“…This device has originally been developed for screening preeclampsia and HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome, but its potential application for monitoring spurious hemolysis in whole blood samples is rather obvious. Although the accuracy of cell-free hemoglobin assessment with this system has been claimed to be as high as 90% compared to a standard photometer measurement (50), no external validation has been carried out so far and no indications can be found on how (or where) the software and the hardware can be purchased.…”