Ferreira Javier, Pau Ivan, Lindecrantz Kaj, Seoane Fernando
IEEE J Biomed Health Inform. 2017 Sep;21(5):1224-1232. doi: 10.1109/JBHI.2016.2628766. Epub 2016 Nov 15.
In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented, and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease. Peritoneal dialysis and home haemodialysis are life-saving home-based renal replacement treatments that, compared to conventional in-center hemodialysis, provide similar long-term patient survival, less restrictions of life-style, such as a more flexible diet, and better flexibility in terms of treatment options and locations. Bioimpedance has been largely used clinically for decades in nutrition for assessing body fluid distributions. Moreover, bioimpedance methods are used to assess the overhydratation state of CKD patients, allowing clinicians to estimate the amount of fluid that should be removed by ultrafiltration. In this work, the initial validation of a handheld bioimpedance system for the assessment of body fluid status that could be used to assist the patient in home-based CKD treatments is presented. The body fluid monitoring system comprises a custom-made handheld tetrapolar bioimpedance spectrometer and a textile-based electrode garment for total body fluid assessment. The system performance was evaluated against the same measurements acquired using a commercial bioimpedance spectrometer for medical use on several voluntary subjects. The analysis of the measurement results and the comparison of the fluid estimations indicated that both devices are equivalent from a measurement performance perspective, allowing for its use on ubiquitous e-healthcare dialysis solutions.
近年来，人们做出了许多努力，以推动医疗保健模式从传统的以医院为中心的被动式医疗方法，转向积极主动、以患者为导向且自我管理的方法，这种方法可以提高服务质量，有助于降低成本，并促进可持续发展。在发达国家，管理和护理慢性病患者的费用占医疗保健总费用的75%以上。最消耗资源的疾病之一是慢性肾脏病（CKD），它常常导致肾功能逐渐且不可逆转地丧失，高达12%的人口表现出该疾病不同阶段的症状。腹膜透析和家庭血液透析是挽救生命的居家肾脏替代治疗方法，与传统的中心血液透析相比，它们能为患者提供相似的长期生存率，对生活方式的限制更少，例如饮食更灵活，并且在治疗选择和地点方面具有更好的灵活性。几十年来，生物电阻抗在临床营养领域已被广泛用于评估体液分布。此外，生物电阻抗方法还用于评估CKD患者的水合过度状态，使临床医生能够估计应通过超滤去除的液体量。在这项工作中，展示了一种用于评估体液状态的手持式生物电阻抗系统的初步验证，该系统可用于协助患者进行居家CKD治疗。体液监测系统包括一个定制的手持式四极生物电阻抗光谱仪和一件用于全身体液评估的纺织电极衣。针对在多名自愿受试者身上使用商用医用生物电阻抗光谱仪进行的相同测量，对该系统的性能进行了评估。测量结果分析和液体估计比较表明，从测量性能角度来看，这两种设备是等效的，这使得它可用于无处不在的电子医疗透析解决方案。
