Інформаційна технологія статистичного управління процедурою ультрафільтрації при програмному гемодіалізі

Abstract

The information technology of statistical control of the procedure of ultrafiltration in program hemodialysis based on information obtained from bioimpedanceometry signals is proposed in the article. The analysis of the literature sources showed the urgent need to develop a system of informational support for the procedure of hemodialysis or its automation. Imperfection of the classical methods of assessing the level of hydration of the patient does not allow using them as signals indicating the state of the biological object in real time. The analytical review showed that the most suitable signal by which the patient's condition can be monitored is the bioimpedanceometry signal. The aim of the work was the development of information technology for monitoring the patient's condition and statistical management of the ultrafiltration procedure based on bioimpedanceometry signals. To analyze such signals, covariance analysis was chosen, since it allows estimating global and local signal trends taking into account its nonstationarity, as well as assessing the significance of changing these trends. In the work, based on the classical covariance decomposition, a modified covariance method of analysis was proposed. This method allows to take into account the relative change of bioimpedance signals trends at several frequencies, and, thereby, reducing the sum of the random remaining residue. This approach allows obtaining an additional informative parameter by increasing the sensitivity of the method to dynamic changes. Experimental studies on patients undergoing programmed hemodialysis showed the effectiveness of the proposed method. The adequacy of the statistical solutions obtained was fully confirmed by the results of a control study – measurement of the hematocrit level.