Absolute blood volume estimation device and method
Absolute blood volume in dialysis patients is a useful patient attribute to know for dialysis treatment, diagnosis, adjustments, etc. In some cases, it is difficult or impossible to directly determine absolute blood volume. Estimating absolute blood volume may be used to overcome the inability to directly determine the absolute blood volume. Estimating absolute blood volume may include obtaining a series of measurements of hemoconcentration of a patient over a time period, and estimating parameters for a physiological model based on the series of measurements. The absolute blood volume of the patient may be determined using the physiological model.
1. A dialysis machine for estimating absolute blood volume, the dialysis machine comprising:
an injector to inject a predetermined volume of dilution indicator liquid into a blood stream of a patient;
a receiver to obtain, from a sensor, a series of measurements of hemoconcentration of at least one blood characteristic of the patient over a time period, the series of measurements including a hemoconcentration at a dilution test time during the time period, and the series of measurements of hemoconcentration based on blood volume compared to the predetermined volume of dilution indicator liquid;
memory including instructions, which when executed by a processor, cause the processor to:
estimate parameters to generate a physiological model corresponding to the time period, the parameters estimated based on the series of measurements, and the parameters including the hemoconcentration at the dilution test time, a volume of a first compartment and a volume of a second compartment at the dilution test time and at a dilution injection time of the time period, the physiological model being specific to the patient and the time period; and
determine an absolute blood volume of the patient at a specified time using the physiological model and the series of measurements of hemoconcentration; and
a display portion to display the absolute blood volume.
2. The dialysis machine of claim 1 , wherein the memory includes instructions to further cause the processor to prescribe a dialysis treatment action for the patient based on the absolute blood volume at the dilution test time.
3. The dialysis machine of claim 1 , wherein the memory includes instructions to further cause the processor to modify a dialysis treatment action for the patient automatically based on the absolute blood volume.
4. The dialysis machine of claim 1 , wherein the dilution test time includes a period of ten to fifteen minutes after the dilution injection time, and wherein the injection occurs at the dilution injection time.
5. The dialysis machine of claim 1 , wherein the time period includes a period before the dilution injection time and the series of measurements include measurements taken during the period before the dilution injection time for a baseline.
6. The dialysis machine of claim 1 , wherein the estimated parameters include a blood exchange between the first and second compartments, a fluid exchange with interstitial space, and a time delay.
7. The dialysis machine of claim 1 , wherein estimating the parameters includes fitting the physiological model to the series of measurements by performing a nonlinear least squares fit and minimizing a root-mean-square error between the series of measurements and relative blood volume estimates resulting from the physiological model.
8. The dialysis machine of claim 1 , wherein the series of measurements of hemoconcentration include a series of measurements of at least one of a relative blood volume, a blood volume monitor (BVM) measurement, or a hematocrit measurement.