Abstract
Abstract. The individualization of dialysis treatment using a customized dialysate composition usually requires a continuous measurement of electrolytes and urea in blood. The current practices are spot measurements of blood samples either with blood gas analyzers or in the laboratory, involving considerable personnel effort. Furthermore, the measured values are time delayed and not available in a continuous fashion. In this paper we investigate an in-line concept for continuous monitoring of important blood parameters such as sodium, potassium, calcium and urea concentrations in blood serum using ion-selective electrodes. This concept is evaluated in a preclinical study with human packed red blood cells as a test medium over a period of 7 h. It has been shown that the electrolytes can be well monitored. In addition, we present first measurements with ion-sensitive field-effect transistors in a miniaturized sensor assembly. Therefore, new low-cost electronics for such ion-sensitive field-effect transistors have been developed.
Highlights
It is shown that the measured sodium, potassium and calcium concentrations agree very well with the blood gas analyzer values used as a reference system
As we move towards miniaturization, we have tried ionsensitive field-effect transistors (ISFETs) purchased from D+T Microelectrónica, A.I.E. instead of using large and expensive standard ion-selective electrodes (ISEs)
With respect to cross-sensitivities, the interferences between the calcium ion-sensitive field-effect transistors (ISFETs) and potassium ISFET in relation to sodium described by KCa,Na and KK,Na are important, since the fluctuation of sodium is the most significant
Summary
The individualization of dialysis treatment is receiving increasing attention in research as critically ill patients in intensive care units (ICUs) with acute kidney injury (AKI) benefit from it (Palmer, 2001; Locatelli et al, 2015; Sharma et al, 2016; Kovesdy et al, 2007; Paula et al, 2004; Stiller et al, 2001). While intermittent dialysis aims at the maximum clearance of waste products and the normalization of electrolytes at a treatment with a duration of 3–4 h, CRRT focuses on a significantly slower normalization of blood parameters over a treatment duration of several days, which is beneficial for critically ill patients as a rapid change in osmotic substances can lead to different complications (Patel et al, 2010; Sivalingam and Farrington, 2007; Stiller et al, 2001). It is beneficial to continuously monitor the blood urea concentration in order to evaluate the efficiency of dialysis treatment in line and in real time. The results are time delayed and not available in a continuous fashion
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