A novel, non-invasive, optical device for the measurement of total haemoglobin and stroke volume, and for the identification of fluid responsiveness – initial clinical evaluation

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dc.availability.bitstreamopenaccess
dc.contributor.advisorBreen, Dorothyen
dc.contributor.advisorexternalAllen, Saraen
dc.contributor.authorBroderick, Alan Jonathan
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderUniversity of Limericken
dc.date.accessioned2020-09-09T09:21:03Z
dc.date.available2020-09-09T09:21:03Z
dc.date.issued2019-10
dc.date.submitted2019-10
dc.description.abstractHaemoglobin is a molecule present in red blood cells and is essential for adequate oxygen delivery to tissues. It is measured frequently in many clinical situations, particularly intraoperatively. Until recently, it was only possible to measure haemoglobin through blood testing which is an invasive process and requires some time to process. Devices have been developed in the last number of years to minimise both the invasiveness and time needed to measure haemoglobin. More recently, devices are available that provide instant or continuous results without requiring blood samples but these have not been universally accepted into clinical practice. Stroke volume is the amount of blood ejected from the heart at each heartbeat, and is one of the determinants of cardiac output (which is also responsible for ensuring adequate tissue oxygen delivery). It varies across many clinical states, particularly following major haemorrhage or reduced cardiac function. The analysis of variations in stroke volume during the respiratory cycle (i.e. between the end of a complete exhalation and the end of the following complete exhalation) has been shown to predict when a patient’s stroke volume could be improved by administering intravenous fluid. Successfully identifying such ‘responders’ can lead to earlier appropriate treatment, and also avoid over-treatment. However, at present the most reliable methods of measuring stoke volume or predicting fluid responsiveness involve the use of invasive devices which have the potential to be harmful. A novel device has been developed which uses the absorbance of red and near-infrared light across a finger tip as the basis for the measurement of both haemoglobin and stroke volume, along with the prediction of fluid responsiveness. This is non-invasive and would allow for the continuous measurement of these physiological parameters, with potential for more efficient and timely treatment.This thesis presents the first clinical evaluation of the two functions of this novel device across three studies. The first study investigated the measurement of haemoglobin by this device across twenty five patients undergoing heart surgery who each underwent four samples. The second study looked into the measurement of haemoglobin in one hundred pregnant women during their twenty- week antenatal clinic visit. In both studies, the results from the device were compared with the standard laboratory method of measurement. The third study investigated the device’s ability to measure stoke volume and to predict fluid responsiveness in twenty patients undergoing heart surgery. The results of these studies showed that the device is currently not suitable for use in clinical practice as a replacement for the more established methods of measurement one each case. Some explanation is offered regarding the poor results.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationBroderick, A. J. 2019. A novel, non-invasive, optical device for the measurement of total haemoglobin and stroke volume, and for the identification of fluid responsiveness – initial clinical evaluation. MD Thesis, University College Cork.en
dc.identifier.endpage231en
dc.identifier.urihttps://hdl.handle.net/10468/10492
dc.language.isoenen
dc.publisherUniversity College Corken
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Frontiers Programme (RFP)/11/RFP.1/ECE/3335/IE/Security Enabled Pervasive Biometric Sensors/en
dc.relation.projectUniversity of Limerick (Graduate Entry Medical School(GEMS), SRF fund)en
dc.rights© 2019, Alan J. Broderick.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectPhotoplethysmographyen
dc.subjectPPGen
dc.subjectHaemoglobinen
dc.subjectFluid responsivenessen
dc.subjectPoint-of-care medical devicesen
dc.subjectIntraoperative monitoringen
dc.subjectNon-invasive monitoringen
dc.subjectMedical devicesen
dc.subjectStroke volumeen
dc.subjectClinical evaluationen
dc.titleA novel, non-invasive, optical device for the measurement of total haemoglobin and stroke volume, and for the identification of fluid responsiveness – initial clinical evaluationen
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnameMD - Doctor of Medicineen
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