In vivo real-time monitoring of tissue perfusion via L-lactate levels in interstitial fluid: an innovative and portable microfluidic device trial using a pig model

BACKGROUND: The postoperative assessment of the tissue is a major challenge in reconstructive flap surgery. Lactate serves as a key indicator of metabolic dysfunction, providing essential insights into tissue oxygenation and perfusion, cellular stress, and identifying potential pathological conditions. Consequently, continuous monitoring of lactate levels is vital for postoperative tissue analysis in patients undergoing microvascular tissue transfer to prevent serious complications. However, methodologies for the time-resolved sensing of metabolic biomarkers across various body fluids still pose a major challenge and are currently out of reach. MATERIALS AND METHODS: To address the need for time-resolved detection, we developed an innovative portable device relying on droplet-based microfluidics technology for monitoring lactate levels in interstitial fluids (ISFs) in an enzyme-based fluorometric manner. This device was evaluated on individual animal samples and during in vivo trials, with results benchmarked against a standard clinical blood gas analyzer. RESULTS: System demonstrates high accuracy and sensitivity (limit of detection of ca . 2 µM versus 100 µM for the clinical method), coupled with a short response time ( ca. 0.5 minutes) and reagent-saving process (reducing 90% reagent usage in traditional methods). Using a microdialysis probe, we enabled continuous and minimally invasive collection of ISF dialysate. The lactate measurements in ISF closely correlate with those obtained from the blood gas analyzer and exhibited long-term stability, delivering high temporal resolution (0.5 seconds intervals) over an 8-hour animal trial. Comparative analysis revealed that lactate levels in ISF were consistently higher and exhibited a slight lag compared to blood lactate levels. CONCLUSION: This approach demonstrated highly selective, sensitive, and robust detection of lactate in a clinical environment, with a microfluidics-powered instrument. We expect that this strategy can be used in the future as a tool for time-resolved biomarkers monitoring for bedside postoperative care.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Explore how this research connects to clinical practice

More peer-reviewed studies in Clinical Trials.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →