title: Simple, Reagentless Quantification of Total Bilirubin in Blood Via Microfluidic Phototreatment and Image Analysis.
abstract: Total bilirubin (T-Bil) is an important clinical diagnostic marker that is measured frequently by physicians to assist in the diagnosis, treatment, and monitoring of multiple medical conditions. The work demonstrated here utilizes the 48-year-old mechanism of phototherapy that is commonly implemented in the treatment of infants with exaggerated physiologic and pathologic jaundice but adapts it to the microfluidic level for the ultimate purpose of total bilirubin quantitation. After acquisition of a small volume of blood (<10 μL) and through subsequent separation (plasma + red blood cells), a 3 μL plasma sample was imaged by a portable scanner and analyzed through a custom algorithm for color intensity. After blue light irradiation for 10 min at 470 nm, the sample was reimaged and analyzed. The resulting intensities obtained pre- and postimaging (clearly observed through a color change from yellow to clear) were then utilized to calculate the total bilirubin concentration. A total of 34 blood samples were analyzed with microfluidic photo treatment-image analysis (μPIA) and were found to have a Deming-regression slope of 0.97 (R2= 0.960) when compared to the total bilirubin values determined in the clinical laboratory. We demonstrate the implementation of a centrifugal microdevice fabricated through the Print, Cut, and Laminate (PCL) method that accepts eight whole blood samples and provides the capabilities to not only quantitate total bilirubin (Deming-regression slope of 0.95, R2= 0.990) but allow future integration with excess plasma sufficient for additional downstream clinical assays. This work will highlight the inexpensive nature of the analysis (absence of caustic, viscous, or additional reagents), the simplicity (does not require any chemical reactions), speed (sample-to-answer in <15 min), insusceptibility to biofouling (no protein matrix effects, hemoglobin interferences, and minimized turbidity), low volume plasma requirement (3 μL), and the ability for future downstream integration.
authors.affiliation: Department of Chemistry, University of Virginia , Charlottesville, Virginia 22904, United States.
authors.forename: Brandon L
authors.identifier: 0000-0003-2276-8451
authors.initials: BL
authors.lastname: Thompson
authors.affiliation: Department of Chemistry, University of Virginia , Charlottesville, Virginia 22904, United States.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Wyckoff
authors.affiliation: Department of Pathology, University of Virginia Health Science Center , Charlottesville, Virginia 22908, United States.
authors.forename: Doris M
authors.initials: DM
authors.lastname: Haverstick
authors.affiliation: Department of Chemistry, University of Virginia , Charlottesville, Virginia 22904, United States.|Department of Pathology, University of Virginia Health Science Center , Charlottesville, Virginia 22908, United States.|Department of Mechanical and Aerospace Engineering, University of Virginia , Charlottesville, Virginia 22904, United States.
authors.forename: James P
authors.initials: JP
authors.lastname: Landers
mesh_terms: D000465:Algorithms; D001663:Bilirubin / Q000097:blood* / Q000737:chemistry; D006801:Humans; D054023:Lasers, Semiconductor; D008027:Light; D044085:Microfluidics / Q000295:instrumentation / Q000379:methods*; D010084:Oxidation-Reduction
chemical_list: D001663:Bilirubin