Optical Identification of Parenteral Nutrition Solutions Exploiting Refractive Index Sensing

Parenteral artificial nutrition (PAN) is a lifesaving treatment for a large population of patients affected by different diseases, and it consists of intravenous injection of nutritive fluids by means of infusion pumps. Wrong PAN solutions are, unfortunately, often administered, thus threatening the patients’ well-being. Here, we report an optofluidic label-free sensor that can distinguish PAN solutions on the basis of their volumetric refractive index (RI). In our system, a monochromatic light beam, generated by a laser diode, travels obliquely through a transparent, square-section polystyrene channel, is then back-reflected by a mirror, and finally exits the channel in a position that depends on the filling fluid RI. The displacement of the output light spot ΔXexperim is easily detected with a linear, 1-D position sensitive detector (PSD). We initially calibrated the sensor with water-glucose solutions demonstrating a sensitivity S = ΔXexperim/Δn = 13,960 µm/RIU. We then clearly distinguished six commercial PAN solutions, commonly administered to patients. To the best of our knowledge, this is the first reported healthcare sensing platform for remote contactless recognition of PAN fluids, which could be inserted into infusion pumps to improve treatment safety, by checking the compliance to the prescription of the fluid actually delivered to the patient.

[1]  Marta S. Ferreira,et al.  Optical Fiber Sensor for Monitoring the Evaporation of Ethanol–Water Mixtures , 2022, Sensors.

[2]  Swapna A. Jaywant,et al.  Sensors and Instruments for Brix Measurement: A Review , 2022, Sensors.

[3]  Cuihua Ma,et al.  Fiber Optic Sensors Based on Circular and Elliptical Polymer Optical Fiber for Measuring Refractive Index of Liquids , 2022, SSRN Electronic Journal.

[4]  A. Fox,et al.  Patient Safety Incidents Related to the Use of Parenteral Nutrition in All Patient Groups: A Systematic Scoping Review , 2021, Drug Safety.

[5]  V. Singh,et al.  A review on infiltrated or liquid core fiber optic SPR sensors , 2021 .

[6]  Yu Zhang,et al.  Side-Polished D-Type Fiber SPR Sensor for RI Sensing With Temperature Compensation , 2021, IEEE Sensors Journal.

[7]  F. D. De Rosa,et al.  The Central Role of Clinical Nutrition in COVID-19 Patients During and After Hospitalization in Intensive Care Unit , 2020, SN Comprehensive Clinical Medicine.

[8]  E. Houdayer,et al.  Nutritional management of COVID-19 patients in a rehabilitation unit , 2020, European Journal of Clinical Nutrition.

[9]  Z. Saleem,et al.  Dosing errors in total parenteral nutrition prescriptions at a specialized cancer care hospital of Lahore: The role of clinical pharmacist , 2020, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners.

[10]  A. Forbes,et al.  ESPEN practical guideline: Clinical Nutrition in inflammatory bowel disease. , 2020, Clinical nutrition.

[11]  C. Mølgaard,et al.  ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition. , 2018, Clinical nutrition.

[12]  R. Dickerson,et al.  Avoiding Patient Harm With Parenteral Nutrition During Electrolyte Shortages , 2018, Hospital pharmacy.

[13]  Vickie Baracos,et al.  ESPEN guidelines on nutrition in cancer patients. , 2017, Clinical nutrition.

[14]  A. Gossum,et al.  ESPEN guidelines on definitions and terminology of clinical nutrition. , 2017, Clinical nutrition.

[15]  J. Lightdale,et al.  Discrepancies Between Prescribed and Actual Pediatric Home Parenteral Nutrition Solutions. , 2016, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[16]  M. Mackay,et al.  Frequency and Severity of Parenteral Nutrition Medication Errors at a Large Children's Hospital After Implementation of Electronic Ordering and Compounding. , 2016, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[17]  Eric S. Kirkendall,et al.  Automated detection of medication administration errors in neonatal intensive care , 2015, J. Biomed. Informatics.

[18]  Yao-Xiong Huang,et al.  Dependence of Refractive Index on Concentration and Temperature in Electrolyte Solution, Polar Solution, Nonpolar Solution, and Protein Solution , 2015 .

[19]  Matthew C Grissinger Mismatched prescribing and pharmacy templates for parenteral nutrition lead to data-entry errors. , 2015, P & T : a peer-reviewed journal for formulary management.

[20]  W. Barfield,et al.  Zinc Deficiency–Associated Dermatitis in Infants During a Nationwide Shortage of Injectable Zinc — Washington, DC, and Houston, Texas, 2012–2013 , 2014, MMWR. Morbidity and mortality weekly report.

[21]  Michael R. Cohen,et al.  Important Change with Heparin Labels; Benadryl Dispensed Instead of Vitamins for Home Parenteral Nutrition; Potassium and Sodium Acetate Injection Mix-Ups; Don't Truncate, Stem, or Shorten Drug Names , 2013 .

[22]  V. V. Tuchin,et al.  Photonic crystal fibers for food quality analysis , 2012, Photonics Europe.

[23]  Michael R. Cohen,et al.  Another Tragic Parenteral Nutrition Compounding Error: Change in Anzemet Indication: Teva's Lansoprazole Orally Disentegrating Tablet Clogs Tubes: Lawyers Weigh in on Consistent Use of Smart Pump Libraries , 2011 .

[24]  Matthew C Grissinger,et al.  A fatal zinc overdose in a neonate: confusion of micrograms with milligrams. , 2011, P & T : a peer-reviewed journal for formulary management.

[25]  P. Brown,et al.  On the distribution of protein refractive index increments. , 2011, Biophysical journal.

[26]  Y. C. Seow,et al.  An optofluidic refractive index sensor based on partial refraction , 2010 .

[27]  Steve Rough,et al.  Frequency and Severity of Harm of Medication Errors Related to the Parenteral Nutrition Process in a Large University Teaching Hospital , 2009, Pharmacotherapy.

[28]  V. Tuchin,et al.  Biophotonics: Photonic Solutions for Better Health Care , 2008 .

[29]  Ming-Jyi Jang,et al.  Real-time measurement of glucose concentration using position sensing detector , 2008, 2008 3rd IEEE International Conference on Nano/Micro Engineered and Molecular Systems.

[30]  T. Johnson,et al.  Managing children and adolescents on parenteral nutrition: challenges for the nutritional support team , 2006, Proceedings of the Nutrition Society.

[31]  Shyam Singh Refractive Index Measurement and its Applications , 2002 .

[32]  Franco Docchio,et al.  A simple and reliable system for measuring the refractive index of liquids using a position-sensitive detector , 1995 .

[33]  S. Nemoto,et al.  Measurement of the refractive index of liquid using laser beam displacement. , 1992, Applied optics.

[34]  Akio Nishimoto,et al.  Remote refractive index difference meter for salinity sensor , 1989 .