Hemoscan™: A Dialysis Machine-Integrated Blood Volume Monitor

In earlier studies, a reduction in intradialytic procedures was observed in patients with severe intradialytic hypotension symptomatology by the use of blood volume controlled biofeedback systems. However, few data are present on the use of biofeedback-controlled treatments in patients experiencing minor intradialytic symptoms. In the present study, 157 standard and 158 biofeedback-controlled treatments were compared during a 2-month period in 16 hemodialysis patients. Both the percentage of hypotensive episodes (6.3 ± 11.3 vs. 15.8 ± 18.3%; p < 0.05) as well as other intradialytic symptoms (cramps, nausea, headache, abdominal pain) (11.0 ± 12.8 vs. 18.1 ± 16.9%; p < 0.05) were significantly less during biofeedback-controlled treatments compared to standard dialysis treatments, despite a similar decline in relative blood volume (8.8 ± 3.5 vs. 8.3 ± 3.1%; p = n.s.). Interdialytic weight gain and intradialytic rise in plasma sodium levels were comparable. Concluding, in this short-term preliminary study, blood volume controlled biofeedback improved dialysis tolerance also in patients with minor intradialytic symptomatology.

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“…Changes in BV are determined by an on-line optical method [6]. These BV changes are derived from blood hemoglobin concentration changes.…”

Section: Methodsmentioning

confidence: 99%

“…A correction is made for the in vivo erythrocyte-wall scattering of the emitted light, an effect that is related to the mean erythrocyte volume, not its contents. This validated optical method is virtually insensitive to error from oxygen saturation, blood flow, osmotic pressure, and hydraulic pressure [6]. …”

Section: Methodsmentioning

confidence: 99%

Blood Volume Control by Biofeedback and Dialysis-Induced Symptomatology

Wolkotte

Hassell

Moret

et al. 2002

Nephron

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“…⌬RBV were measured with Hemoscan (Gambro-Hospal). In addition, we assessed ⌬RBV from changes in Ht (⌬RBV-Ht) in afferent blood because this method is considered to be the reference method for determining ⌬RBV during HD (5,22).…”

Section: Study Protocolmentioning

confidence: 99%

Relative Blood Volume Changes Underestimate Total Blood Volume Changes during Hemodialysis

Dasselaar

Hooge

Pruim

et al. 2007

Clinical Journal of the American Society of Nephrology

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Background: Measurements of relative blood volume changes (⌬RBV) during hemodialysis (HD) are based on hemoconcentration and assume uniform mixing of erythrocytes and plasma throughout the circulation. However, whole-body hematocrit (Ht) is lower than systemic Ht. During HD, a change in the ratio between whole-body to systemic Ht (F cell ratio) is likely to occur as a result of a net shift of low Ht blood from the microcirculation to the macrocirculation. Hence, ⌬RBV may differ significantly from total blood volume changes (⌬TBV). Therefore, this study compared ⌬RBV and ⌬TBV during HD.Design, setting, participants, and measurements: Plasma and erythrocyte volumes were measured using 125 I-and 123 Iradioiodinated albumin and 51 Cr-labeled erythrocytes, respectively. After validation of the standardized method in two patients on a nondialysis day, seven patients completed the protocol during HD.125 I-albumin and 51 Cr-labeled erythrocytes were administered 20 min before the start of HD.123 I-albumin was administered at 160 min into the HD session to quantify and correct for 125 I-albumin leakage. ⌬RBV was measured continuously throughout HD. The F cell ratio was derived from whole-body and systemic Ht.Results: Total ultrafiltration volume was 2450 ؎ 770 ml. TBV declined from 5905 ؎ 824 to 4877 ؎ 722 ml during HD. Thus, TBV declined 17.3 ؎ 4.4%, whereas the RBV decline was only 8.2 ؎ 3.7% (P ‫؍‬ 0.001). The F cell ratio increased from 0.896 ؎ 0.036 to 0.993 ؎ 0.049 during HD (P ‫؍‬ 0.002).Conclusions: ⌬RBV significantly underestimates ⌬TBV during HD. The rise in F cell ratio strongly suggests that during HD, blood translocates from the microcirculation to the macrocirculation, probably as a cardiovascular compensatory mechanism in response to hypovolemia.

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“…Non-invasive sensors are particularly useful to avoid the expense of disposable material and probes [16], [18], [20], [21]. Optical sensors are mainly used for the purpose of relative blood volume (RBV) estimation [22], [23], but other uses have also been proposed [16], [17], [19], [24], [25]. Relative blood volume is defined as the relative variation in volume of the body's blood compartment in comparison with that at the beginning of the session.…”

Section: B Optical Sensors In Hemodialysis and Hemofiltrationmentioning

confidence: 99%

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

Visotti¹,

Ravagli

Perazzini³

et al. 2018

IEEE Sensors J.

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Abstract-Hemofiltration (HF) is a group of blood purification therapies used to treat patients with kidney injury. HF works using a process called ultrafiltration (UF) that removes excess liquid accumulated in the patient's body caused by lack of excretion. UF progress is monitored by the HF machine, but the state-of-the-art method is cumbersome and could be more accurate. In this work, a system composed by two optical sensors is proposed for real-time non-invasive estimation of ultrafiltration rate. This new system is simple, rugged, low-cost and operates on sound theoretical foundations. The sensor system has been tested with two different experimental protocols and showed good correlation between its output and the reference value of the ultrafiltration rate (R 2 =0.97), as well as improved accuracy compared to the available commercial machine (≃12ml/h). This system also has the potential to simplify the architecture required by critical care blood purification machines to perform UF control.Index Terms -Biomedical Measurement, Blood, Blood Purification, Hemofiltration, Hemoglobin, Measurement, Optical Sensor, Ultrafiltration I. INTRODUCTIONRenal replacement therapies (RRTs) have been developed to treat individuals affected by kidney failure, known as nephropathic patients. RRTs have the following targets:• Removal of excess fluid accumulated by the patient due to lack of kidney excretion.• Re-balancing concentration of specific substances in blood, for example electrolytes such as sodium.• Removal of the toxic by-products of metabolism, such as urea.Several types of therapies and machines have been developed. The main distinction of therapies is between those developed † First two authors A. Visotti and E. Ravagli contributed equally to this work. A. Visotti, C. Perazzini, D. Drudi, and C. Ghidini are with the company IBD Srl (https://www.ibdsrl.com/), Forlì, Italy.E. Ravagli and S. Severi* are with the Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy (e-mail: stefano.severi@unibo.it).to treat patients with acute kidney injury (AKI), who are expected to partially or fully regain kidney functionality, and those for patients with chronic kidney disease (CKD), who require periodic treatment for the rest of their lives or until kidney transplant. Therapies such as hemodialysis [1]-[3] and peritoneal dialysis [4] are the standard for CKD patients; while for AKI, slow, prolonged, one-time treatments are chosen to perform blood purification until kidney function is regained [5]- [7]. The effect of RRTs on the patient has been studied both clinically and with mathematical tools such as kinetic models, developed to describe the transfer of water and solutes across body compartments during .This work represents a technological improvement for AKI therapies where fluid removal is the main target -therapies also known as hemofiltration (HF). Fluid removal is performed by means of a physical principle called ultrafiltration (UF) [11]-[13]. Example...

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Hemoscan™: A Dialysis Machine-Integrated Blood Volume Monitor

Cited by 63 publications

References 9 publications

Blood Volume Control by Biofeedback and Dialysis-Induced Symptomatology

Blood Volume Control by Biofeedback and Dialysis-Induced Symptomatology

Relative Blood Volume Changes Underestimate Total Blood Volume Changes during Hemodialysis

A Differential Optical Sensor for Non-Invasive Real-Time Monitoring of Ultrafiltration Rate in Hemofiltration Therapies

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