Automated end-to-end blood testing at the point-of-care: Integration of robotic phlebotomy with downstream sample processing

Abstract

Diagnostic blood testing is the most commonly performed clinical procedure in the world, and influences the majority of medical decisions made in hospital and laboratory settings. However, manual blood draw success rates are dependent on clinician skill and patient physiology, and results are generated almost exclusively in centralized labs from large-volume samples using labor-intensive analytical techniques. This paper presents a medical device that enables end-to-end blood testing by performing blood draws and providing diagnostic results in a fully automated fashion at the point-of-care. The system couples an image-guided venipuncture robot, developed to address the challenges of routine venous access, with a centrifuge-based blood analyzer to obtain quantitative measurements of hematology. We first demonstrate a white blood cell assay on the analyzer, using a blood mimicking fluid spiked with fluorescent microbeads, where the area of the packed bead layer is correlated with the bead concentration. Next we perform experiments to evaluate the pumping efficiency of the sample handling module. Finally, studies are conducted on the integrated device — from blood draw to analysis — using blood vessel phantoms to assess the accuracy and repeatability of the resulting white blood cell assay.

Deep learning robotic guidance for autonomous vascular access

“…Outside the hospital, robotic technologies could allow emergency medical providers to obtain rapid vascular access under time-critical conditions and bring advanced interventional and resuscitation capabilities to remote and resource-limited environments 11 . Finally, the device has the potential to serve as a platform to merge automated phlebotomy and diagnostic blood analysis, facilitating the provision of critical haematological information at the point of the blood draw 49,50 .…”

First-in-human evaluation of a hand-held automated venipuncture device for rapid venous blood draws

“…Previous iterations of the venipuncture device have been designed in our laboratory for benchtop use and were not manually operated by the user, as they were in this study. The motivation for the benchtop design was for performing high-throughput blood draw procedures that would be used in junction with a point-of-care blood diagnostic system, as is described by Balter et al 32 . In this benchtop design, the device used NIR passive stereo imaging to identify a suitable insertion site on the patient's upper forearm area.…”

“…In this benchtop design, the device used NIR passive stereo imaging to identify a suitable insertion site on the patient's upper forearm area. Once found, the attached ultrasound probe was robotically lowered over the chosen site and the needle insertion commenced 22,31,32 . In the hand-held version demonstrated in this paper, ultrasound imaging is used alone for image guidance, as NIR imaging is no longer required because the user is now manually placing the device over the insertion site.…”

“…To address the challenges of DVA, our laboratory is developing an automated venipuncture device for obtaining venous access safely and reliably. Previously, we developed a benchtop venipuncture device for point-of-care blood analysis that featured a 9-degree-of-freedom (DOF) robotic system that utilized NIR imaging and computer vision processing to identify suitable vessels for cannulation and ultrasound imaging to guide the robotic needle insertion 22,31,32 . However, its large size, lack of mobility, and large number of DOF make it difficult to implement in a number of clinical scenarios requiring rapid venous access, especially in emergency situations where patient mobility is restricted.…”

Service Robots in the Healthcare Sector

“…Despite being the most commonly performed medical procedure in the world, diagnostic blood testing can have different success rates as drawing blood is not only dependent on the physician's skill, but also on the patient's physiology [41]. Furthermore, the results of blood samples are generally generated in labour-intensive labs.…”