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Monitoring intracellular, interstitial, and intravascular volume changes during fluid management procedures

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An Erratum to this article was published on 05 July 2013

Abstract

The bioimpedance spectroscopic (BIS) analytical algorithm described in this report allows for the non-invasive measurement of intravascular, interstitial, and intracellular volume changes during various fluid management procedures. The purpose of this study was to test clinical use feasibility and to demonstrate the validity of the BIS algorithm in computing compartmental volume shifts in human subjects undergoing fluid management treatment. Validation was performed using volume changes recorded from 20 end stage renal disease patients. The validation procedure involved mathematically deriving post hoc hematocrit profiles from the BIS data-generated fluid redistribution time profiles. These derived hematocrit profiles were then compared to serial hematocrit values measured simultaneously by a CritLine® monitor during 60 routine hemodialysis sessions. Regression and Bland–Altman analyses confirm that the BIS algorithm can be used to reliably derive the continuous and real-time rates of change of the compartmental fluid volumes. Regression results yielded a R 2 > 0.99 between the two measures of hematocrit at different times during dialysis. The slopes of the regression equations at the different times were nearly identical, demonstrating an almost one-to-one correspondence between the BIS and CritLine® hematocrits. Bland–Altman analysis show that the BIS algorithm can be used interchangeably with the CritLine® monitor for the measurement of hematocrit. The present study demonstrates for the first time that BIS can provide real-time continuous measurements of compartmental intravascular, interstitial and intracellular fluid volume changes during fluid management procedures when used in conjunction with this new algorithm.

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Acknowledgments

This work was funded, in part, by the National Heart, Lung and Blood Institute of the National Institutes of Health through SBIR Grants 1 R43 HL074524-01 and 2 R44 HL074524-02A2 entitled, “Intra/Extracellular Volume and Hemodynamics” between 1 September 2003 and 31 July 2008. The authors wish to thank Ms. Sharon Hanish, Brian Scholfield, and Marty Loughry of UFI, Inc., Morro Bay, CA for their technical support and encouragement during this project. We, especially thank Dr. Jennifer E. Flythe of Brigham and Women’s Hospital, Harvard Medical School for her assistance in editing this manuscript.

Conflict of interest

The authors from LDM Associates were the recipients of the National Heart, Lung and Blood Institute of the National Institutes of Health through SBIR Grants 1 R43 HL074524-01 and 2 R44 HL074524-02A2 entitled, “Intra/Extracellular Volume and Hemodynamics” 1 September 2003 and 31 July 2008. None of the authors has received or will receive any compensation or monetary benefit from the publication of this article.

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Authors and Affiliations

  1. LDM Associates, 1764 Emory Street, San Jose, CA, 95126, USA

    Leslie D. Montgomery, Wayne A. Gerth & Richard W. Montgomery

  2. George Washington University, Washington, DC, USA

    Susie Q. Lew & Manuel T. Velasquez

  3. New York Medical College, New York, NY, USA

    Michael M. Klein & Julian M. Stewart

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  1. Leslie D. Montgomery
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  2. Wayne A. Gerth
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  3. Richard W. Montgomery
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  7. Manuel T. Velasquez
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Correspondence to Leslie D. Montgomery.

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Montgomery, L.D., Gerth, W.A., Montgomery, R.W. et al. Monitoring intracellular, interstitial, and intravascular volume changes during fluid management procedures. Med Biol Eng Comput 51, 1167–1175 (2013). https://doi.org/10.1007/s11517-013-1064-3

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  • DOI: https://doi.org/10.1007/s11517-013-1064-3

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