On-line monitoring of electrolytes in hemodialysis: on the road towards individualizing treatment

Sharma, Manoj K.; Wieringa, Fokko; Frijns, Ajh Arjan; Kooman, Jeroen P.

doi:10.1080/17434440.2016.1230494

Cited by 37 publications

(18 citation statements)

References 96 publications

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“…Since blood parameters such as electrolyte and urea concentrations are of great medical interest, various monitoring concepts have been developed (Sharma et al, 2016). There are already devices on the market that can determine the URR online by evaluating the conductivity of the dialysate (Diascan ® Gambro Hospal GmbH; OCM; Fresenius).…”

Section: State Of the Art And Conceptmentioning

confidence: 99%

“…However, for reasons of hemo-and biocompatibility, a direct in-line measurement with ISEs in blood is usually not possible (Gavalas et al, 2006). Proteins can adsorb on the ion-selective membrane of the ISEs, leading to a so-called membrane fouling, causing a time-dependent drift of the sensor signal (Sharma et al, 2016). More importantly, the adsorbed proteins can trigger blood coagulation and hemolysis and thus threaten the patient's life, making direct measurement in blood flow impossible.…”

Section: State Of the Art And Conceptmentioning

confidence: 99%

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Continuous in-line monitoring of electrolyte concentrations in extracorporeal circuits for individualization of dialysis treatment

Berger

Faulstich

Perl

et al. 2018

J. Sens. Sens. Syst.

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Abstract. One objective of dialysis treatment is to normalize the blood plasma electrolytes and remove waste products such as urea and creatinine from blood. However, due to a shift in plasma osmolarity, a rapid or excessive change of the electrolytes can lead to complications like cardiovascular instability, overhydrating of cells, disequilibrium syndrome and cardiac arrhythmias. Especially for critical ill patients in intensive care unit with sepsis or multi-organ failure, any additional stress has to be avoided. Since the exchange velocity of the electrolytes mainly depends on the concentration gradients across the dialysis membrane between blood and dialysate, it can be controlled by an individualized composition of dialysate concentrations. In order to obtain a precise concentration gradient with the individualized dialysate, it is necessary to continuously monitor the plasma concentrations. However, with in-line sensors, the required hemocompatibility is often difficult to achieve. In this work, we present a concept for continuous in-line monitoring of electrolyte concentrations using ion-selective electrodes separated from the blood flow by a dialysis membrane, and therefore meeting the fluidic requirements for hemocompatibility. First investigations of hemocompatibility with reconfigured human blood show no increased hemolysis caused by the measuring system. With this concept, it is possible to continuously measure the plasma concentrations with a relative error of less than 0.5 %.

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Section: State Of the Art And Conceptmentioning

confidence: 99%

Section: State Of the Art And Conceptmentioning

confidence: 99%

Continuous in-line monitoring of electrolyte concentrations in extracorporeal circuits for individualization of dialysis treatment

Berger

Faulstich

Perl

et al. 2018

J. Sens. Sens. Syst.

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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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“…The processor module is mainly composed of C8051F996 microprocessor and its peripheral circuits, which is the core control module of the system. CPU uses Silicon Labs 8051 microprocessor C8051F996 to perform processing, communication and other functions of data [4]. The wireless communication module is mainly composed of nRF905 chip and its peripheral circuits, which is the RF communication module of the node.…”

Section: Hardware Design Of Monitoring System For Substation Equipmentmentioning

confidence: 99%

Design and Application of Electrical Equipment Overheating Monitoring Based on Wireless Sensor

Liu

2017

Int. J. Onl. Eng.

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Abstract-A new scheme is proposed to solve the practical problems in the intelligent monitoring of 220kV substation equipment. By analyzing the changes in temperature of substation electrical equipment, it applies wireless sensor network technology in the inverter station based on the running condition of the equipment. In addition, the acquisition, processing, and communication of temperature information is used as the major research object, and a kind of intelligent monitoring of substation equipment system based on wireless sensor network is designed. By using C805IF996 chip and nRF905 chip as the main chips, the hardware and software design of the temperature data acquisition node and sink node are realized. The result show that the electrical equipment based on wireless sensor has a great impact in overheating monitoring. Based on the above finding, a conclusion is drawn that wireless sensor provides an effective solution for the application of intelligent monitoring of electrical equipment.Keywords-wireless sensor, temperature monitoring, acquisition node, sink node IntroductionFor high voltage electrical equipment in substation, it is easy to appear insulation aging or too large contacted resistance phenomenon during the long time of operation, and it will lead to overheating, cause fires and large scale blackouts, and bring about significant economic losses. Since that a large proportion of the temperature change of substation high voltage electrical equipment can reflect the running state of the equipment, it is of practical value for make a real-time temperature monitoring on the substation equipment [1]. Along with the continuous development of computer technology, wireless communication and sensor technology, wireless sensor network (Wireless Sensor Network, WSN) with the integration of sensor technology, information processing technology and wireless communication technology comes into being. This paper applies the wireless sensor network technology in the inverter staiJOE -Vol. 13, No. 7, 2017 25

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On-line monitoring of electrolytes in hemodialysis: on the road towards individualizing treatment

Cited by 37 publications

References 96 publications

Continuous in-line monitoring of electrolyte concentrations in extracorporeal circuits for individualization of dialysis treatment

Continuous in-line monitoring of electrolyte concentrations in extracorporeal circuits for individualization of dialysis treatment

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

Design and Application of Electrical Equipment Overheating Monitoring Based on Wireless Sensor

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