CA2418974A1 - Device and method for segmental bioimpedance measurements of a dialysis patient - Google Patents

Device and method for segmental bioimpedance measurements of a dialysis patient Download PDF

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Publication number
CA2418974A1
CA2418974A1 CA002418974A CA2418974A CA2418974A1 CA 2418974 A1 CA2418974 A1 CA 2418974A1 CA 002418974 A CA002418974 A CA 002418974A CA 2418974 A CA2418974 A CA 2418974A CA 2418974 A1 CA2418974 A1 CA 2418974A1
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Canada
Prior art keywords
body segment
pressure
segment
measurement unit
resistivity
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002418974A
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French (fr)
Other versions
CA2418974C (en
Inventor
Fansan Zhu
Nathan Levin
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Fresenius Medical Care Holdings Inc
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Individual
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Priority to CA2752137A priority Critical patent/CA2752137A1/en
Publication of CA2418974A1 publication Critical patent/CA2418974A1/en
Application granted granted Critical
Publication of CA2418974C publication Critical patent/CA2418974C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/05Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0537Measuring body composition by impedance, e.g. tissue hydration or fat content
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021Measuring pressure in heart or blood vessels
    • A61B5/022Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026Measuring blood flow
    • A61B5/0295Measuring blood flow using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/05Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/053Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0535Impedance plethysmography
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4869Determining body composition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/33Controlling, regulating or measuring
    • A61M2205/3379Masses, volumes, levels of fluids in reservoirs, flow rates
    • A61M2205/3393Masses, volumes, levels of fluids in reservoirs, flow rates by weighing the reservoir
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/50General characteristics of the apparatus with microprocessors or computers

Abstract

The present invention includes a method of determining the dry body weight o f a patient undergoing dialysis by means of segmental bioimpedance analysis. I n preferred embodiments, dry body weight is determined by comparison to the bioimpedance values of normal subjects or by monitoring changes in bioimpedance during dialysis. One embodiment of the present invention is a device for determining dry body weight during dialysis.

Claims (31)

1. A method for determining the hydration status of a dialysis patient comprising the steps of:

measuring the resistivity of a body segment of the patient;
correlating the measured resistivity with predetermined normal dry weight values; and deriving the patient's hydration status.
2. The method of claim 1, wherein the resistivity of the interstitial fluid in the body segment is measured.
3. The method of claim 1, wherein the resistivity of the body segment is determined while applying a pressure of at least about systolic blood pressure.
4. The method of claim 3, wherein the pressure is applied from about 120 mmHg to about 240 mmHg .
5. The method of claim 1, wherein the body segment is a limb segment.
6. The method of claim 1, wherein the body segment is a thigh segment.
7. A method for determining a hemodialysis patient's dry weight comprising the steps of:

periodically measuring the resistivity of a body segment during hemodialysis;

comparing successive resistivity measurements; and identifying the patient's dry weight when a substantially constant resistivity is reached.
8. The method of claim 7, wherein the resistivity of the body segment is measured from about every 5 minutes to about every 20 minutes during hemodialysis.
9. The method of claim 8, wherein the resistivity of the body segment is measured about every 10 minutes during hemodialysis.
10. The method of claim 7, wherein the resistivity of the body segment is measured at a pressure of at least about systolic blood pressure.
11. The method of claim 10, wherein the pressure is from about 120 mmHg to about mmHg.
12. A method for dialysing a patient to the patient's dry weight comprising the steps of:
measuring the resistivity of a body segment of the patient;
correlating the measured resistivity with predetermined normal dry weight values; deriving the patient's hydration; and continuing hemodialysis until the resistivity of the body segment correlates with the predetermined normal dry weight values.
13. The method of claim 12, wherein the resistivity of the body segment is measured at a pressure of at least about systolic blood pressure.
14. A method for hemodialysing a patient to the patient's dry weight comprising the steps of:
periodically measuring the resistivity of a body segment during hemodialysis;
comparing successive resistivity measurements; and discontinuing hemodialysis when a substantially constant resistivity is reflected.
15. The method of claim 14, wherein the resistivity of the body segment is measured at a pressure of at least about systolic blood pressure.
16. The method of claim 14, wherein the resistivity of the body segment is measured from about every 5 minutes to about every 20 minutes during hemodialysis.
17. A method of monitoring the heart rate of a hemodialysis patient comprising the steps of:
determining a time interval between two successive bioimpedance wave peaks;
and multiplying the reciprocal of the time interval by 60 to obtain the heart rate.
18. A method of calculating the cardiac output of a patient in need thereof comprising the steps of:
measuring the stroke volume in an arm segment by bioimpedance analysis;
substantially simultaneously measuring the stroke volume in an ipsalateral leg segment by bioimpedance analysis;
summing the stroke volume in the arm segment and the stroke volume in the leg segment; and multiplying the sum by twice the heart rate to obtain the cardiac output.
19. The method of claim 18, wherein stroke volume of the arm segment is calculated by applying an external maximum pressure to the arm segment and determining the change in blood volume in the arm segment between the point of maximum pressure and the point at which no external pressure is applied divided by the number of heart beats between the two points in time, and wherein the stroke volume of the leg is calculated by applying an external maximum pressure to the leg segment and determining the change in blood volume in the leg segment between the point of maximum pressure and the point at which no external pressure is applied divided by the number of heart beats between two points in time.
20. A device for controlling a hemodialysis machine comprising:
a bioimpedance analysis measurement unit in electrical communication with a hemodialysis machine;

an electrical output means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to a body segment, the electrical output means being adapted to apply electrical current to the body segment;

an electrical input means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to a body segment, the electrical input means being adapted to receive the current transmitted through the body segment and transmit the same to the bioimpedance analysis measurement unit;
and wherein the bioimpedance analysis measurement unit is adapted to determine body segment resistivity based on the current transmitted through the body segment and wherein the bioimpedance analysis measurement unit provides feedback to the hemodialysis machine in response to the body segment resistivity.
21. The device of claim 20 further including means for applying pressure to the body segment, the pressure applying means being in electrical communication with the bioimpedance analysis measurement unit.
22. The device of claim 21 wherein the pressure applying means includes a pressure cuff, the pressure cuff being adapted to encircle the body segment.
23. The device of claim 22 wherein the electrical output means includes at least two injector electrodes, the electrical input means includes at least two measurement electrodes, and wherein the injector electrodes and the measurement electrodes are secured to the pressure cuff.
24. The device of claim 23 wherein the pressure cuff further includes at least one conductive band with opposing ends and at least one conductive plate positioned adjacent one of the ends of the conductive band, the conductive band extends substantially the length of the pressure cuff, the conductive plate is arranged to electrically contact the conductive band at a point along the length of the same wherein the distance between the conductive plate and the point of contact of the conductive band is substantially equal to the circumference of the body segment, and wherein the bioimpedance measurement unit is adapted to electrically determine body segment circumference based on the distance between the end of the band adjacent to the plate and the point of contact of the plate along the length of the band.
25. A device for monitoring hydration status in a hemodialysis patient comprising:
a bioimpedance analysis measurement unit;
an electrical output means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to a body segment, the electrical output means being adapted to apply electrical current to the body segment;
an electrical input means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to a body segment, the electrical input means being adapted to receive the current transmitted through the body segment and transmit the same to the bioimpedance analysis measurement unit;
and wherein the bioimpedance analysis measurement unit is adapted to determine body segment resistivity based on the current transmitted through the body segment.
26. The device of claim 25 further including means for applying pressure to the body segment, the pressure applying means being in electrical communication with the bioimpedance analysis measurement unit.
27. The device of claim 26 wherein the pressure applying means includes a pressure cuff, the pressure cuff being adapted to encircle the body segment.
28. The device of claim 27 wherein the electrical output means includes at least two injector electrodes, the electrical input means includes at least two measurement electrodes, and wherein the injector electrodes and the measurement electrodes are secured to the pressure cuff.
29. The device of claim 28 wherein the pressure cuff further includes at least one conductive band with opposing ends and a conductive plate positioned adjacent one of the ends of the conductive band, the conductive band extends substantially the length of the pressure cuff, the conductive plate is arranged to electrically contact the conductive band at a point along the length of the same wherein the distance between the conductive plate and the point of contact of the conductive band is substantially equal to the circumference of the body segment, and wherein the bioimpedance measurement unit is adapted to electrically determine body segment circumference based on the distance between the end of the band adjacent to the plate and the point of contact of the plate along the length of the band.
30. A hemodialysis machine including the device of claim 25.
31. A device for calculating cardiac output through bioimpedance measurements of a patient comprising:
a bioimpedance measurement unit;
a first electrical output means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to an arm segment, the first electrical output means being adapted to apply electrical current to the arm segment;
a second electrical output means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to a leg segment, the second electrical output means being adapted to apply electrical current to the leg segment;
a first electrical input means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to an arm segment, the electrical input means being adapted to receive the current transmitted through the arm segment and transmit the same to the bioimpedance analysis measurement unit;
a second electrical input means being in electrical communication with the bioimpedance analysis measurement unit and being attachable to a leg segment, the electrical input means being adapted to receive the current transmitted through the leg segment and transmit the same to the bioimpedance analysis measurement unit;
a first pressure applying means for applying a maximum pressure to the arm segment; pressure to the body segment, the first pressure applying means being in electrical communication with the bioimpedance analysis measurement unit.

a second pressure applying means for applying a maximum pressure to the arm segment, the second pressure applying means being in electrical communication with the bioimpedance analysis measurement unit;
means for selectively electronically connecting the bioimpedance analysis measurement between the first electrical input and output mans and the second electrical input and output means, and wherein the bioimpedance analysis measurement unit is adapted to selectively measure stroke volume in the arm and leg segments by bioimpedance analysis.
CA2418974A 2000-08-14 2001-08-13 Device and method for segmental bioimpedance measurements of a dialysis patient Expired - Fee Related CA2418974C (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA2752137A CA2752137A1 (en) 2000-08-14 2001-08-13 Device and method for segmental bioimpedance measurements of a dialysis patient

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/638,657 2000-08-14
US09/638,657 US6615077B1 (en) 2000-08-14 2000-08-14 Device and method for monitoring and controlling physiologic parameters of a dialysis patient using segmental bioimpedence
PCT/US2001/025309 WO2002013691A1 (en) 2000-08-14 2001-08-13 Device and method for segmental bioimpedance measurements of a dialysis patient

Related Child Applications (1)

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CA2752137A Division CA2752137A1 (en) 2000-08-14 2001-08-13 Device and method for segmental bioimpedance measurements of a dialysis patient

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CA2418974A1 true CA2418974A1 (en) 2002-02-21
CA2418974C CA2418974C (en) 2011-11-29

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CA2752137A Abandoned CA2752137A1 (en) 2000-08-14 2001-08-13 Device and method for segmental bioimpedance measurements of a dialysis patient

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US (1) US6615077B1 (en)
EP (3) EP1645227B1 (en)
JP (5) JP5175019B2 (en)
AT (1) ATE312550T1 (en)
AU (1) AU2001284863A1 (en)
CA (2) CA2418974C (en)
DE (3) DE60115907T2 (en)
WO (1) WO2002013691A1 (en)

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