Method and apparatus for direct spectrophotometric measurements in unaltered whole blood

Abstract

A method and apparatus that allows accurate spectrophotometric determination of the concentrations of various hemoglobin species in whole undiluted blood. The invention employs 1) an optical apparatus designed to maximize the true optical absorbance of whole blood and to minimize the effects of light scattering on the spectrophotometric measurements of the concentrations of various constituent components, and 2) methods to correct the hemoglobin concentration measurements for light scattering and for the effects of the finite bandwidth of the substantially monochromatic light. In the optical apparatus optical parameters, such as sample thickness, detector size, sample-to-detector distance, wavelengths, monochromicity, and maximum angle of light capture by detector, are selected so as to minimize the contribution of light scattering and to maximize the contribution of true optical absorbance. After making measurements of a blood sample's optical density at each of the wavelengths, corrections are made for the effects of light scattering.

Description

[0001] A portion of the disclosure of this patent document contains material which is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever. FIELD OF THE INVENTION [0002] This invention relates to a method and apparatus to assess the optical transmittance of a sample of unaltered whole blood at multiple wavelengths to attain an accurate measurement of its total hemoglobin concentration, the concentration of bilirubin, and the concentrations of oxy-, deoxy-, carboxy-, met-, and sulfhemoglobin. BACKGROUND [0003] To the best of the Applicants' knowledge, no prior art whether patented or not has ever successfully exploited the optical transmittance of unaltered whole blood to achieve an accurate measurement of the total hemoglobin concentration (THb) in a bl...

AI Technical Summary

Benefits of technology

[0015] By making spectrophotometric measurements directly on unaltered whole blood and by correcting for the effects of light scattering on the measurements, the present invention eliminates the need to hemolyze the blood sample and the need to chemically convert the various hemoglobin derivatives to a single species. Thus, the present invention overcomes the previously mentioned disadvantages of prior art that employs hemolysis only, hemolysis and dilution, or chemical conversion. By contrast, the present invention makes appropriate measurements of the light scattering by red blood cells and of other light losses in unaltered, whole blood and then uses its assessment of these light losses to correct mathematically the measurements of total hemoglobin concentration and the concentrations of the individual hemoglobin species. By eliminating the need for a hemolyzing apparatus, the present invention avoids the problems caused by hemolysis such as the fragmentation of red and white blood cells into light-scattering particles. Furthermore, the need for pumps, plumbing, and associated control circuitry is eliminated by use of an inexpensive disposable cuvette. Therefore, the problem of clogging of the apparatus is eliminated, and the nondestructive optical test performed by the present invention preserves the blood sample (with its red blood cells intact) for further subsequent analysis.

[0017] 1. A spectrophotometric apparatus (including an optical cuvette) in which all optical parameters (for example, sample thickness, detector size and shape, sample-to-detector distance, wavelengths, monochromicity, and maximum angle of light capture by detector) are optimal values so as to minimize the contribution of light scattering to the total optical attenuation of unaltered whole blood and so as to maximize the contribution of true optical absorbance.

Problems solved by technology

Because the individual hemoglobin species differ significantly from each other in their optical absorbance spectra, no method that employs a single wavelength can measure the total hemoglobin concentration spectrophotometrically.

The disadvantages of the above-mentioned chemical conversion methods are that 1) hemolysis and accurate dilutions are needed, 2) the reagents are often toxic, 3) chemical conversion is slow, 4) the red blood cells and the chemical nature of the whole blood sample are so drastically altered that the same sample cannot be used for further subsequent analyses of other blood constituents, and 5) the chemical conversion of the various hemoglobin derivatives into a single species makes it impossible to measure the original concentrations of the several individual species.

The latter disadvantage is a serious limitation because the concentrations of oxy-, carboxy-, met-, deoxy-, and sulfhemoglobin provide valuable diagnostic information in many different medical applications.

These prior methods eliminate the need for chemically converting the various hemoglobin derivatives into a single species, but they suffer from the disadvantage of requiring a complex, bulky, and expensive apparatus comprised of pumps, plumbing, associated control circuitry, and in some cases, ultrasonic hemolyzers to dilute and hemolyze the blood sample.

Finally, the techniques that employ hemolysis have two additional disadvantages: 1) their complicated plumbing systems are prone to clogging by blood residue, and 2) they aspirate and destroy the blood sample so that it cannot be retrieved and subjected to further analysis of other constituents.

In whole blood, the major obstacle to making optical measurements is the intense light scattering caused by the highly concentrated red blood cells, e.g. 5.4×106 RBCs / μl for human males.

Prior art that relies on hemolysis to eliminate the intense light scattering by the red blood cells has the further disadvantage that even after thorough hemolysis the sample can be relatively turbid (L. R. Sehgal et al., Critical Care Medicine, 12:907-909, 1984).

Nevertheless, the residual turbidity in hemolyzed blood causes troublesome errors in the hemoglobin measurements.

Thus, an additional disadvantage of prior apparatus that rely on hemolysis is the residual turbidity that results from a small number of unlysed red blood cells, lipid particles such as chylomicrons (a normal constituent of plasma that persists after hemolysis), light-scattering cell fragments produced by the hemolysis process, and other causes that are unknown.

First, as mentioned previously, the turbidity of hemolyzed blood is insignificant in magnitude in comparison with the light scattering of unhemolyzed whole blood.

Prior art was not designed to accommodate the greater magnitude of the scattering effects of unaltered whole blood.

The Applicants have discovered that, even though most of the light is scattered at small angles, the magnitude of large-angle light scattering is sufficient to cause serious errors in spectrophotometric measurements on whole blood.

Prior art does not address the problem of designing practical instruments by capturing the large-angle light scattering of unhemolyzed blood.

Prior art does not address the complex wavelength dependence of the scattering effects of unaltered whole blood.

Prior art does not address the complex dependence of light scattering on the concentrations of the individual hemoglobin species in unaltered whole blood.

Fifth, many poorly understood, uncontrolled processes occur in unaltered, whole blood that change its optical properties.

As shown in the comparative example below, the apparatus of Lundsgaard, U.S. Pat. No. 4,997,769, fails to yield valid results when measuring a sample of unaltered (unhemolyzed) whole blood.

Similarly, other prior art that relies on hemolysis such as Brown et al., U.S. Pat. No. 4,134,678; Raffaele, U.S. Pat. No. 4,013,417; and Johansen et al., U.S. Pat. No. 3,972,614 would also fail to yield valid results on unhemolyzed whole blood because these methods also fail to capture the light scattered at large angles by the sample, and because their measurements do not take into account the magnitude, the wavelength dependence, or the hemoglobin-composition-dependence of the light-scattering effects of unaltered whole blood.

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