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Portable Droplet-Based Real-Time Monitoring of Pancreatic α-Amylase in Postoperative Patients

Zhao, X.; Kolbinger, F. R.; Distler, M.; Weitz, J.; Makarov, D.; Bachmann, M.; Baraban, L.

Postoperative complications after pancreatic surgery are frequent and can be life-threatening. Current clinical diagnostic strategies involve time-consuming quantification of α-amylase activity in abdominal drain fluid, which is performed on the first and third postoperative day. The lack of real-time monitoring may delay adjustment of medical treatment upon complications and worsen prognosis for patients. We report a bedside portable droplet-based millifluidic device enabling real-time sensing of drain α-amylase activity for postoperative monitoring of patients undergoing pancreatic surgery. Here, a tiny amount of drain liquid of patient samples is continuously collected and co-encapsulated with a starch reagent in nanoliter-sized droplets to track the fluorescence intensity released upon reaction with α-amylase. Comparing the α-amylase levels of 32 patients, 97% of the results of the droplet-based millifluidic system matched the clinical data. Our method reduces the α-amylase assay duration to approximately three minutes with the limit of detection 7 nmol/s·L, enabling amylase activity monitoring at the bedside in clinical real-time. The presented droplet-based platform can be extended for analysis of different body fluids, diseases, and towards a broader range of biomarkers, including lipase, bilirubin, lactate, inflammation, or liquid biopsy markers, paving the way towards new standards in postoperative patient monitoring.

Keywords: pancreatic surgery; postoperative pancreatic fistula; pancreatic α-amylase; droplet-based millifluidics; point-of-care diagnostics

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Permalink: https://www.hzdr.de/publications/Publ-38002