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Electrical admittance method for estimating fluid removal during artificial dialysis

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Abstract

Because the conductivity of blood changes remarkably during artificial dialysis, sometimes by more than 20%, changes in tissue admittance at low frequency are caused by changes not only in the extracellular fluid volume but also in blood conductivity. Therefore the changes in blood conductance due to artificial dialysis must be considered for the estimation of water removal by the admittance method. An accurate bio-impedance measurement system was developed. Measurement error was less than 1% at low frequency and 10% at high frequency. A new electrical bio-admittance method (NAM) was evaluated for the continous measurement of removed fluid volume, using a three parallel-compartment tissue model, consisting of intracellular, interstitial and blood compartments, which takes into account the blood conductivity change. NAM used the equivalent conductivity calculated from the leg admittances of patients, measured at 1 min intervals during various artificial dialysis procedures. The actual amount of excess water removed by ultra-filtration agreed with the NAM-estimated amount within an error of 20%. NAM was also applied to estimate the intra-and extracellular fluid changes. The results were consistent with the physiological changes known to occur during the various forms of dialysis.

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Abbreviations

NAM:

new electrical bio-admittance measurement method

HD:

haemodialysis

HDF:

haemodiafiltration

HF:

haemofiltration

HSD:

high sodium dialysis

Ht :

haematocrit value

ΔHt :

increasing value ofHt

V r :

volume of water removed during artificial dialysis

V c :

saline solution volume infused into vein

V x :

interstitial fluid volume that shifts into blood region

V leg :

volume at measured part of leg

V rleg :

decreasing volume ofV leg owing toV r

V cleg :

increasing volume ofV leg owing toV c

V :

volume of whole body

V e :

interstitial fluid volume of leg or whole body

V i :

intracellular fluid volume of leg or whole body

V b :

blood volume of leg or whole body

ΔV b :

increasing volume ofV b

ΔV i :

increasing volume ofV i

ΔV e :

increasing volume ofV e

S e :

cross-sectional areas of interstitial fluid region

S b :

cross-sectional areas of blood region

S i :

cross-sectional areas of intracellular fluid region

S leg :

cross-sectional area at measured part of leg

L leg :

length at measured part of leg

L :

height of whole body

Y :

admittance measured in leg

Y L :

Y at low frequency

Y H :

Y at high frequency

ΔY :

increasing admittance ofY

σ:

equivalent complex conductivity of leg

σ L , σ H :

equivalent conductivities of leg at low and high frequencies, respectively

Δσ L , Δσ H :

increasing conductivities of σ L and σ H , respectively

σ′:

(Y+ΔY) L 2 leg /V leg

σ′ L σ′ H :

σ′ at low and high frequencies, respectively

Δσ:

ΔY(L 2 leg /V leg )+σ(V rleg −V cleg )/V leg

Δσ′:

ΔY(L 2 leg /V leg )

Δσ′ L Δσ′ H :

Δσ′ at low and high frequencies, respectively

σ e :

equivalent conductivity of interstitial fluid

σ i :

equivalent conductivity of intracellular fluid

σ b :

blood conductivity

Δσ b :

increasing conductivity of σ e

W :

weight

ρ:

density of whole body

E r :

estimation error

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Authors and Affiliations

  1. Department of Clinical Engineering, Kitasato University, Kanagawa, Japan

    K. Sakamoto

  2. Department of Electrical & Electronics Engineering, Sophia University, Tokyo, Japan

    H. Kanai

  3. Department of Electronics Engineering, Tokyo Metropolitan College of Aeronautical Engineering, Tokyo, Japan

    N. Furuya

Authors
  1. K. Sakamoto
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  2. H. Kanai
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  3. N. Furuya
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Correspondence to K. Sakamoto.

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Sakamoto, K., Kanai, H. & Furuya, N. Electrical admittance method for estimating fluid removal during artificial dialysis. Med. Biol. Eng. Comput. 42, 356–365 (2004). https://doi.org/10.1007/BF02344712

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  • DOI: https://doi.org/10.1007/BF02344712

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