Abstract
A noninvasive investigation to ascertain the hematocrit (HCT) or packed cell volume (PCV) was conducted on 44 hospitalized dengue hemorrhagic fever (DHF) subjects, male and female aged between 3 and 14 years using bioelectrical impedance analysis (BIA). Among the 44 subjects, 30 subjects were confirmed to be non-structural protein-1 (NS1) positive at the time of admission, whose blood investigations such as HCT level, platelet (PLT) count, aspartate aminotransferase (AST) level and alanine aminotransferase (ALT) level were taken for the classification of risk as low risk (LR) and high risk (HR) DHF. Electrical conductivity of blood reflects a linear correlation with HCT. To provide a better and more accurate estimate of HCT, a dual frequency method is proposed to calculate the conductivities of plasma and blood cells. The resistance at 100 kHz is used to estimate the conductivity of blood cells and the impedance at 5 kHz to estimate the conductivity of plasma. Statistical analysis reveals that the HCT estimated using the proposed dual frequency method shows a significant difference with a single frequency (50 kHz) estimate of HCT and also shows a good correlation with the blood investigation results. In addition, statistical analysis of the proposed method on different fever subjects indicates a significant difference with DHF.
Acknowledgments
We would also like to thank Dr. P. Narayanan, Dr. R. Sandanalakshmi and Dr. R. Soundravally, co-investigators of the DST project for their immense contributions and help. We also express our thanks to Director and staff of JIPMER Hospital for their cooperation and support.
Author Statement
Research funding: The work was financial supported by the Department of Science and Technology (DST), New Delhi, India (IDP/MED/2012/15 dated 25.3.2014).
Conflict of interest: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all the control and dengue subjects before the study was performed.
Ethical approval: The research related to human use complied with all the relevant national regulations and institutional policies and was performed in accordance to the tenets of the Declaration of Helsinki and has been approval by JIPMER, Puducherry, India (ECR/324/Inst/PY/2013 dated 22.10.2013).
References
[1] WHO. World Health Organization: Dengue: Guidelines for diagnosis, Treatment, Prevention and Control – New Edition. Geneva, Switzerland: WHO; 2009.Search in Google Scholar
[2] Grimnes S, Martinsen OG. Bioimpedance and Bioelectricity Basics. London, UK: Academic Press; 2015:1–585.10.1016/B978-0-12-411470-8.00001-5Search in Google Scholar
[3] Sutherland PE. Principles of Electrical Safety. Wiley, USA: IEEE Press; 2015:1–795.10.1002/9781118886397Search in Google Scholar
[4] Klassen P, Mazariegos M, Deurenberg P, Solomons NW, Furst P. Hydrational status assessed by bioelectrical impedance spectroscopy and dilution methods in patients with classical dengue fever. Ann N Y Acad Sci 2000;904:163–70.10.1111/j.1749-6632.2000.tb06442.xSearch in Google Scholar PubMed
[5] Ibrahim F, Guan CC, Taib MN, Wan Abas WAB. The characteristic hydration status changes by bioelectrical impedance assessment in female dengue haemorrhagic fever (DHF) patients. Med J Malaysia 2002;57:98.Search in Google Scholar
[6] Ibrahim F, Ooi KF, Ismail NA, Taib MN, Wan Abas WAB. Analysis of water compartment in dengue patients. Proceedings of the 27th Annual International Conference of the Engineering in Medicine and Biology Society, Shanghai, China, 1–5 September 2005; 2005:4130–3.10.1109/IEMBS.2005.1615372Search in Google Scholar
[7] Kamat DK, Bagul D, Patil PM. Classification and applications of bio-impedance measurement techniques. Int J Eng Innov Technol 2014;3:89–91.Search in Google Scholar
[8] Khalil SF, Mohktar MS, Ibrahim F. The theory and fundamentals of bioimpedance analysis in clinical status monitoring and diagnosis of diseases. Sensors 2014;14:10895–928.10.3390/s140610895Search in Google Scholar PubMed
[9] Ibrahim F, Ismail NA, Taib MN, Wan Abas WAB. Modeling of hemoglobin in dengue fever and dengue hemorrhagic fever using bioelectrical impedance. Physiol Meas 2004;25:607–15.10.1088/0967-3334/25/3/002Search in Google Scholar PubMed
[10] Ibrahim F, Taib MN, Abas WAB, Guan CC, Sulaiman S. A novel approach to classify risk in dengue hemorrhagic fever (DHF) using bioelectrical impedance analysis (BIA). IEEE Trans Instrum Meas 2005;54:237–44.10.1109/TIM.2004.840237Search in Google Scholar
[11] Ibrahim F, Wan Abas WAB, Taib MN, Guan CC, Sulaiman S. A new approach to classify risk in dengue infection using bioelectrical impedance analysis. Dengue Bull 2007;31:58–74.Search in Google Scholar
[12] Lukaski H, Bolonchuk W. Estimation of body fluid volumes using tetrapolar bioelectrical impedance measurements. Aviat Space Environ Med 1988;59:1163–9.Search in Google Scholar PubMed
[13] Ar Rawi AH, Moghavvimi M, Ibrahim W. Novel idea to monitor and measure blood hemoglobin noninvasively. Afr J Biotechnol 2010;9:9295–306.Search in Google Scholar
[14] Okada RH, Schwan HP. An electrical method to determine haematocrit’s. IRE Trans Med Electron 1960;7:188–92.10.1109/IRET-ME.1960.5008044Search in Google Scholar PubMed
[15] Ibrahim F, Ismail NA, Taib MN, Bakar WA, Abast W, Sulaiman S, et al. Assessment of Haematocrit Status using Bioelectrical Impedance Analysis in Dengue Patients. Melbourne, Australia: IFAC Modelling and Control in Biomedical Systems; 2003:277–81.10.1016/S1474-6670(17)33515-2Search in Google Scholar
[16] Cole KS. Membranes Ions and Impulses. Berkeley: University of California Press; 1968.10.1525/9780520326514Search in Google Scholar
[17] Frewer RA. The effect of frequency changes on the electrical conductance of moving and stationary blood. Med Biol Eng Comp 1972;10:734–41.10.1007/BF02477384Search in Google Scholar
[18] Zhao TX. New applications of electrical impedance of human blood. J Med Eng Technol 1996;20:115–20.10.3109/03091909609008389Search in Google Scholar PubMed
[19] Ibrahim F, Gilbert Thio TH, Faisal T, Neuman M. The application of biomedical engineering techniques to the diagnosis and management of tropical diseases: a review. Sensors 2015;15:6947–95.10.3390/s150306947Search in Google Scholar
[20] Cha K, Faris RG, Brown EF, Wilmore DW. An eleJ Malaysia 2002;57:98.Search in Google Scholar
[21] Rahim HA, Taib MN, Ibrahim F, Rahim RA. Bioelectrical impedance analysis device: measurement of bioelectrical tissue conductivity in dengue patients. Sensors Trans 2011;125:256–65.Search in Google Scholar
[22] Ulgen Y, Sezdi M. Estimating the resistivity of the interior fluid of red blood cells using Fricke’s equation. Proceedings – 19th International Conference-IEEE/EMBS, Chicago, USA; 1997:2112–5.Search in Google Scholar
[23] Stewart N. Researches on the circulation time and on the influences which affect it. J Physiol 1897;22:158–83.10.1113/jphysiol.1897.sp000684Search in Google Scholar
[24] Fricke H. A mathematical treatment of the electrical conductivity and capacity of disperse systems. I. The electric conductivity of a suspension of homogeneous spheroids. Phys Rev 1924;24:575–87.10.1103/PhysRev.24.575Search in Google Scholar
[25] Fricke H. A mathematical treatment of the electric conductivity and capacity of disperse systems. II. The capacity of a suspension of conducting spheroids surrounded by a non-conducting membrane for a current of low frequency. Phys Rev 1925;26:678–81.10.1103/PhysRev.26.678Search in Google Scholar
[26] Libraty DH, Endy TP, Kalayanarooj S, Chansiriwongs W, Nisalak A, Green S, et al. Assessment of body fluid compartment volumes by multifrequency bioelectrical impedance spectroscopy in children with dengue. Trans R Soc Trop Med Hyg 2002;96:295–9.10.1016/S0035-9203(02)90104-5Search in Google Scholar PubMed
[27] Fricke H, Morse S. Electric resistance and capacity of blood for frequencies between 800 and 4½ million cycles. J Gen Physiol 1925;20:153–67.10.1085/jgp.9.2.153Search in Google Scholar PubMed PubMed Central
[28] Devarasu N, Sudha GF. Investigation on the influence of the extracellular fluid to intracellular fluid ratio at dual frequencies for prognosis of dengue fever in Indian children. Biomed Phys Eng Express 2017;3:1–9.10.1088/2057-1976/aa5700Search in Google Scholar
[29] Velick S, Gorin M. The electrical conductance of suspensions of ellipsoids and its relation to the study of avian erythrocytes. J Gen Physiol 1940;23:753–71.10.1085/jgp.23.6.753Search in Google Scholar PubMed PubMed Central
[30] Yamakoshi K, Tanaka S, Shimazu H. Electrical admittance cuff for noninvasive and simultaneous measurement of haematocrit, arterial pressure and elasticity using volume oscillometric method. Med Biol Eng Comput 1994;32:S99–107.10.1007/BF02523335Search in Google Scholar PubMed
©2019 Walter de Gruyter GmbH, Berlin/Boston
