IASalud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
Engineering Department, School of Architecture, Engineering, & Design, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
PLoS One. 2023 Aug 31;18(8):e0290319. doi: 10.1371/journal.pone.0290319. eCollection 2023.
Urinary flow measurement and colorimetry are vital medical indicators for critically ill patients in intensive care units. However, there is a clinical need for low-cost, continuous urinary flow monitoring devices that can automatically and in real-time measure urine flow. This need led to the development of a non-invasive device that is easy to use and does not require proprietary disposables. The device operates by detecting urine flow using an infrared barrier that returns an unequivocal pattern, and it is capable of measuring the volume of liquid in real-time, storing the history with a precise date, and returning alarms to detect critical trends. The device also has the ability to detect the color of urine, allowing for extended data and detecting problems in catheterized patients such as hematuria. The device is proposed as an automated clinical decision support system that utilizes the concept of the Internet of Medical Things. It works by using a LoRa communication method with the LoRaWAN protocol to maximize the distance to access points, reducing infrastructure costs in massive deployments. The device can send data wirelessly for remote monitoring and allows for the collection of data on a dashboard in a pseudonymous way. Tests conducted on the device using a gold standard medical grade infusion pump and fluid densities within the 1.005 g/ml to 1.030 g/ml urine density range showed that droplets were satisfactorily captured in the range of flows from less than 1 ml/h to 500 ml/h, which are acceptable ranges for urinary flow. Errors ranged below 15%, when compared to the values obtained by the hospital infusion pump used as gold standard. Such values are clinically adequate to detect changes in diuresis patterns, specially at low urine output ranges, related to renal disfunction. Additionally, tests carried out with different color patterns indicate that it detects different colors of urine with a precision in detecting RGB values <5%. In conclusion, the results suggest that the device can be useful in automatically monitoring diuresis and colorimetry in real-time, which can facilitate the work of nursing and provide automatic decision-making support to intensive care physicians.
尿液流量测量和比色法是重症监护病房中危重病患者的重要医学指标。然而，临床需要低成本、连续的尿液流量监测设备，可以自动实时测量尿液流量。这一需求促使开发了一种非侵入性的设备，易于使用且不需要专用的一次性用品。该设备通过使用红外屏障检测尿液流量，该屏障返回明确的模式，并能够实时测量液体体积，精确记录历史数据，并返回警报以检测关键趋势。该设备还能够检测尿液的颜色，从而扩展数据，并检测导管患者（如血尿）的问题。该设备被提议作为一种自动化临床决策支持系统，利用医疗物联网的概念。它通过使用 LoRa 通信方法和 LoRaWAN 协议来最大限度地延长与接入点的距离，从而降低大规模部署的基础设施成本。该设备可以无线发送数据，进行远程监测，并允许以匿名方式在仪表板上收集数据。使用黄金标准的医用级输液泵和在 1.005 g/ml 至 1.030 g/ml 尿液密度范围内的流体密度对该设备进行的测试表明，在 1ml/h 至 500ml/h 的流量范围内，滴液可以令人满意地捕获，这是可接受的尿液流量范围。与用作黄金标准的医院输液泵获得的值相比，误差在 15%以下。这些值在临床上足以检测利尿模式的变化，特别是在与肾功能障碍相关的低尿流量范围内。此外，用不同颜色模式进行的测试表明，它可以检测到不同颜色的尿液，检测 RGB 值的精度小于 5%。总之，结果表明该设备可用于实时自动监测利尿和比色法，这可以方便护理工作，并为重症监护医生提供自动决策支持。
