Abstract
We have developed a sensor for monitoring the hemoglobin () concentration in the effluent of a continuous bladder irrigation. The concentration measurement is based on light absorption within a fixed measuring distance. The light frequency used is selected so that both arterial and venous are equally detected. The sensor allows the measurement of the concentration up to a maximum value of 3.2 g/dL (equivalent to ≈20% blood concentration). Since bubble formation in the outflow tract cannot be avoided with current irrigation systems, a neural network is implemented that can robustly detect air bubbles within the measurement section. The network considers both optical and temporal features and is able to effectively safeguard the measurement process. The sensor supports the use of different irrigants (salt and electrolyte-free solutions) as well as measurement through glass shielding. The sensor can be used in a non-invasive way with current irrigation systems. The sensor is positively tested in a clinical study.
Highlights
In urology, continuous bladder irrigation (CBI) is an important standard care procedure [1,2,3,4] after transurethral resection of the bladder (TURB) or the prostate (TURP)
We found that pure image processing of a single image is not sufficient to reliably detect bubbles: in the case that a bubble of a reasonable size remains static within the light pass, the images can be indistinguishable from images without bubbles at a lower Hb concentration
The full laboratory setup of the CBI monitoring system is shown in Figure 10
Summary
Continuous bladder irrigation (CBI) is an important standard care procedure [1,2,3,4] after transurethral resection of the bladder (TURB) or the prostate (TURP). The dominant goal of CBI is to prevent the formation of blood clots and consecutive bladder tamponade, a medical condition requiring an additional and foremost avoidable follow-up surgery [5]. CBI provides a continuous dilution of the bladder content with fresh irrigation fluid (often saline) and prevents clot formation. Improper CBI may trigger bladder spasms by irritating the bladder, cause undesired bleeding [5], lead to bladder rupture or perforation [6], and might even become life-threatening [7]. These and other possible complications result primarily from increased pressure, due to a high flow rate. CBI demands extensive and continuous supervision and management by medical personnel, imposing a heavy burden on nurses responsible for a whole urological station [8,9]
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