The Memphis Center For Biomedical Engineering in Pediatrics
Serum Osmolality in Pediatric Intensive Care
Project overview by Neel Gandhi
Hyperosmolality is a serious condition that is a consequence of disorders such as diabetic ketoacidosis in children. It is characterized by elevated levels of electrolyte in the blood beyond the normal steady-state ranges. Such a condition could lead to increased blood viscosity, which could aid in embolus formation. In addition, care must be taken to correct hyperosmolality. If the number of electrolyte particles is sharply reduced by IV treatment, there will be an osmotic shift into the hypertonic medium of the brain. A buildup of pressure will force fluid through the foramen magnum and into the brain stem, resulting in the fatal cerebral edema.
This project will address the issue of hyperosmolality from both an instrumentation and a mathematical modeling standpoint. Osmolality is typically measured through its colligative properties, most notably with a freezing point osmometer. This measurement however requires sampling, which could both remove a significant volume of blood from a neonate as well as take a long time. However, it is proposed to measure osmolality through osmotic pressure determination, a method that would record osmolality continuously and inline at the patient's bedside. This ties into the second phase of the project, which will involve a physiological modeling of electrolyte balance. Another goal would be to develop a program to optimize the regimen of fluid administration to the patient, which would be able to correct hyperosmolality in a safe fashion.
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