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At least 19 recordsLinked to original sources

PubMedDate not supplied

Gastric residual volume (GRV) and gastric contents measurement by refractometry.

BACKGROUND: Traditional use of gastric residual volumes (GRVs), obtained by aspiration from a nasogastric tube, is inaccurate and cannot differentiate components of the gastric contents (gastric secretion vs delivered formula). The use of refractometry and 3 mathematical equations has been proposed as a method to calculate the formula concentration, GRV, and formula volume. In this paper, we have validated these mathematical equations so that they can be implemented in clinical practice. METHODS: Each of 16 patients receiving a nasogastric tube had 50 mL of water followed by 100 mL of dietary formula (Osmolite HN, Abbott Laboratories, Columbus, OH) infused into the stomach. After mixing, gastric content was aspirated for the first Brix value (BV) measurement by refractometry. Then, 50 mL of water was infused into the stomach and a second BV was measured. The procedure of infusion of dietary formula (100 mL) and then water (50 mL) was repeated and followed by subsequent BV measurement. The same procedure was performed in an in vitro experiment. Formula concentration, GRV, and formula volume were calculated from the derived mathematical equations. RESULTS: The formula concentrations, GRVs, and formula volumes calculated by using refractometry and the mathematical equations were close to the true values obtained from both in vivo and in vitro validation experiments. CONCLUSIONS: Using this method, measurement of the BV of gastric contents is simple, reproducible, and inexpensive. Refractometry and the derived mathematical equations may be used to measure formula concentration, GRV, and formula volume, and also to serve as a tool for monitoring the gastric contents of patients receiving nasogastric feeding.

Enteral Nutrition↗

PubMed2006

A refractometry-based glucose analysis of body fluids.

In principle, refractometry appears to be a suitable method for the measurement of glucose concentrations in body fluids (such as blood and the intercellular fluid), even though the refractive index of the measured samples, as an additive property, is not specific. But, if certain conditions are fulfilled, the glucose content can be calculated using the refractive index in combination with values from a further measurement. This study describes the determination of the glucose content using refractometry in human blood serum derivates, which were selected - due to their ready availability - to be used as a model for interstitial fluid. Refractometry of body fluids requires the elimination of disturbing components from the measurement sample. First of all, a homogenous fluid (i.e. consisting of one phase) is required, so that all cells and components in suspension need to be separated out. Furthermore, certain dissolved macromolecular components which are known to disturb the measurement process must also be removed. In human serum samples which had been ultrafiltrated with a range of ultrafilters of different pore sizes, a comparative evaluation showed that only ultrafiltration through a filter with a separation limit of between 3 and 30kDa resulted in maximal reduction of the refractive index (compared to native serum), whereas ultrafilters with greater separation limits did not. The total content of osmotically active solutes (the tonicity) also exerts a clear influence. However, exemplary measurements in blood plasma fluid from one volunteer showed that the electrical conductivity is (without an additive component) directly proportional to the osmolality: physiological changes in the state of body hydration (hyperhydration and dehydration) do not lead to any considerable changes in the relation between ionised and uncharged solute particles, but instead result in a sufficiently clear dilution or concentration of the blood fluid's low molecular components. This finding allows the use of the--technically easy to measure--electrical conductivity as a measure for the tonicity of the measurement samples. Using measurements of these two parameters--refractive index and electrical conductivity--in blood serum obtained from a healthy volunteer, a two-dimensional calibration function (calibration matrix) for the assessment of the glucose content of ultrafiltrated human blood serum was constructed, and the measurement of blood glucose levels in non-diabetic (four females and four males) volunteers in comparison to a reference method was evaluated showing (as a proof of concept) a linear association. Assessment of the inaccuracy of these measurements made with the described measuring devices and methods showed a deviation from the reference values of less than 10%. An estimation of the maximum possible error showed relative deviations (maximum measurement uncertainties) of up to 20%.

Adult↗

PubMed2004

Continuous nasogastric tube feeding: monitoring by combined use of refractometry and traditional gastric residual volumes.

BACKGROUND & AIMS: Traditional use of gastric residual volumes (GRVs) is insensitive and cannot distinguish retained enteral formula from the large volume of endogenous secretions. We designed this prospective study to determine whether refractometry and Brix value (BV) measurements could be used to monitor gastric emptying and tolerance in patients receiving continuous enteral feeding. METHODS: Thirty-six patients on continuous nasogastric tube feeding were divided into two groups; patients with lower GRVs (<75 ml) in Group 1, patients with higher GRVs (>75 ml) in Group 2. Upon entry, all gastric contents were aspirated, the volume was recorded (Asp GRV), BV measurements were made by refractometry, and then the contents were reinstilled but diluted with 30 ml additional water. Finally, a small amount was reaspirated and repeat BV measurements were made. Three hours later, the entire procedure was repeated a second time. The BV ratio, calculated (Cal) GRV, and volume of formula remaining were calculated by derived equations. RESULTS: Mean BV ratios were significantly higher for those patients in Group 2 compared to those in Group 1. All but one of the 22 patients (95%) in Group 1 had a volume of formula remaining in the stomach estimated on both measurements to be less than the hourly infusion rate (all these patients had BV ratios <70%). In contrast, six of the 14 patients in Group 2 (43%) on both measurements were estimated to have volumes of formula remaining that were greater than the hourly infusion rate (all these patients had BV ratios >70%). Three of the Group 2 patients (21%) whose initial measurement showed evidence for retention of formula, improved on repeat follow-up measurement assuring adequate gastric emptying. The remaining five patients from Group 2 (35%) had a volume of formula remaining that was less than the hourly infusion rate on both measurements. The pattern of Asp GRVs and serial pre- and post-dilution BVs failed to differentiate these patients in Group 2 with potential emptying problems from those with sufficient gastric emptying. CONCLUSIONS: Refractometry and measurement of the BV may improve the clinical utilization of GRVs, by its ability to identify the component of formula within gastric contents and track changes in that component related to gastric emptying.

Enteral Nutrition↗

PubMed1957

The structure and concentration of solids in photoreceptor cells studied by refractometry and interference microscopy.

Fragments of freshly obtained retinas of several vertebrate species were studied by refractometry, with reference to the structure of the rods and cones. The findings allowed a reassessment of previous descriptions based mainly on fixed material. The refractometric method was used also to measure the refractice indices and to calculate the concentrations of solids and water in the various cell segments. The main quantitative data were confirmed by interference microscopy. When examined by the method of refractometry the outer segments of freshly prepared retinal rods appear homogeneous. Within a few minutes a single eccentric longitudinal fiber appears, and transverse striations may develop. These changes are attributed to imbibition of water and swelling in structures normally too small for detection by light microscopy. The central "core" of outer segments and the chromophobic disc between outer and inner segments appear to be artifacts resulting from shrinkage during dehydration. The fresh outer segments of cones, and the inner segments of rods and cones also are described and illustrated. The volumes, refractive indices, concentrations of solids, and wet and dry weights of various segments of the photoreceptor cells were tabulated. Rod outer segments of the different species vary more than 100-fold in volume and mass but all have concentrations of solids of 40 to 43 per cent. Cone outer segments contain only about 30 per cent solids. The myoids, paraboloids, and ellipsoids of the inner segments likewise have characteristic refractive indices and concentrations of solids. Some of the limitations and particular virtues of refractometry as a method for quantitative analysis of living cells are discussed in comparison with more conventional biochemical techniques. Also the shapes and refractive indices of the various segments of photoreceptor cells are considered in relation to the absorption and transmission of light. The Stiles-Crawford effect can be accounted for on the basis of the structure of cone cells.

Histological Techniques↗

PubMed2003

The reliability and validity of hand-held refractometry water content measures of hydrogel lenses.

PURPOSE: To investigate within- and between-examiner reliability and validity of hand-held refractometry water content measures of hydrogel lenses. METHODS: Nineteen lenses of various nominal water contents were examined by two examiners on two occasions separated by 1 hour. An Atago N2 hand-held refractometer was used for all water content measures. Lenses were presented in a random order to each examiner by a third party, and examiners were masked to any potential lens identifiers. Intraclass correlation coefficients (ICC), 95% limits of agreement, and Wilcoxon signed rank test were used to characterize the within- and between-examiner reliability and validity of lens water content measures. RESULTS: Within-examiner reliability was excellent (ICC, 0.97; 95% limits of agreement, -3.6% to +5.7%), and the inter-visit mean difference of 1.1 +/- 2.4% was not biased (p = 0.08). Between-examiner reliability was also excellent (ICC, 0.98; 95% limits of agreement, -4.1% to +3.9%). The mean difference between examiners was -0.1 +/- 2.1% (p = 0.83). The mean difference between the nominally reported water content and our water content measures was -2.1 +/- 1.7% (p < 0.001); the 95% limits of agreement for this difference were -5.4% to +1.1%. CONCLUSION: There is good reliability within and between examiners in measuring water content of hydrogel lenses. However, with our sample of lenses, examiners tended to overestimate the nominal water content of hydrogel lenses. As discussed, this bias may be associated with the Brix scale used in refractometry and is material dependent. Therefore, investigators may need to account for bias when measuring hydrogel lens water content via hand-held refractometry.

Contact Lenses, Hydrophilic↗

PubMed1980

Estimation of bovine colostral immunoglobulins by refractometry.

The total protein of colostral whey from dairy cows as determined by a refractometer were compared with the immune globulin concentration obtained by cellulose acetate membrane electrophoresis and the immunoglobulin (IgA + IgG + IgM) contents determined by radial immunodiffusion. The coefficient of correlation between the results obtained by refractometry and electrophoresis was 0.98 (P < 0.001). The correlation between refractometry and radial immunodiffusion was 0.89 (P < 0.001), while that of electrophoresis and radial immunodiffusion was 0.87 (P < 0.001). Refractometry can be used as a simple, fast and inexpensive indirect method of assessing immunoglobulins in colostral whey.

Animals↗

PubMed2000

The use of 1H-NMR spectroscopy and refractometry for investigation of the distribution of nonelectrolytes of N-alcohol series between human red blood cells and extracellular medium.

Comparative analysis of 1H NMR spectroscopy and refractometry with respect to their application for investigating the distribution of nonelectrolytes of n-alcohol series (ethanol, 1,2-propanediol, glycerol) and polyethylene glycols (PEGs) with molecular masses of 400, 600, 1500 between human erythrocytes and extracellular medium was performed. The distribution coefficients (Q) for solutions of ethanol, 1,2-propanediol, glycerol, PEG-400, PEG-600 and PEG-1500 were obtained. The Q values decreased with the increase in the nonelectrolyte molecular mass from 1.23+/-0.12 for ethanol to 0.40+/-0.08 for PEG-1500 (1H NMR spectroscopy) and from 2.6+/-0.12 for ethanol to 0.23+/-0.03 for PEG-1500 (refractometry). It was shown that 1H-NMR high-resolution spectroscopy ensures more precise determination of Q values for nonelectrolytes with low molecular masses; for PEGs with high molecular masses, the accuracy of Q value calculation by this method was about 20%. On the contrary, refractometry can be used for investigating substances with high molecular masses; the error of Q value determination for solution of low-refractive substances, such as ethanol, may be more than 50%.

Electrolytes↗

PubMed2006

[Comparisons of manual and automatic refractometry with subjective results].

BACKGROUND: Refractometry is very important in everyday clinical practice. The aim of this study is to compare the precision of three objective methods of refractometry with subjective dioptometry (Phoropter). The objective methods with the smallest deviation to subjective refractometry results are evaluated. MATERIALS AND METHODS: The objective methods/instruments used were retinoscopy, Prism Refractometer PR 60 (Rodenstock) and Auto Refractometer RM-A 7000 (Topcon). The results of monocular dioptometry (sphere, cylinder and axis) of each objective method were compared to the results of the subjective method. The examination was carried out on 178 eyes, which were divided into 3 age-related groups: 6 - 12 years (103 eyes), 13 - 18 years (38 eyes) and older than 18 years (37 eyes). All measurements were made in cycloplegia. RESULTS: The smallest standard deviation of the measurement error was found for the Auto Refractometer RM-A 7000. Both the PR 60 and retinoscopy had a clearly higher standard deviation. Furthermore, the RM-A 7000 showed in three and retinoscopy in four of the nine comparisons a significant bias in the measurement error. CONCLUSIONS: The Auto Refractometer provides measurements with the smallest deviation compared to the subjective method. Here it has to be taken into account that the measurements for the sphere have an average deviation of + 0.2 dpt. In comparison to retinoscopy the examination of children with the RM-A 7000 is difficult. An advantage of the Auto Refractometer is the fast and easy handling, so that measurements can be performed by medical staff.

Adolescent↗

PubMed2002

Rainbow refractometry: simultaneous measurement of temperature, refractive index, and size of droplets.

The capabilities and limitations of rainbow refractometry, specifically the minimum measurable droplet size and the errors in the refractive index (temperature), have been studied. We evaluate what we believe is a new method of indirectly applying the Lorenz-Mie theory to rainbow refractometry. The results show that this new method reduces the errors and eliminates the biases that may occur if the Airy theory is used. A more precise method to filter the high-frequency oscillations associated with the measurement signals was developed. Finally, it was discovered that the errors associated with rainbow refractometry are such that a single droplet measurement is unreliable. A mean refractive index should be determined on the basis of multiple droplet measurements.

Journal Article↗

PubMed2007

Equivalences between refractive index and equilibrium water content of conventional and silicone hydrogel soft contact lenses from automated and manual refractometry.

PURPOSE: The purpose of the present study was to develop mathematical relationships that allow obtaining equilibrium water content and refractive index of conventional and silicone hydrogel soft contact lenses from refractive index measures obtained with automated refractometry or equilibrium water content measures derived from manual refractometry, respectively. METHODS: Twelve HEMA-based hydrogels of different hydration and four siloxane-based polymers were assayed. A manual refractometer and a digital refractometer were used. Polynomial models obtained from the sucrose curves of equilibrium water content against refractive index and vice-versa were used either considering the whole range of sucrose concentrations (16-100% equilibrium water content) or a range confined to the equilibrium water content of current soft contact lenses (approximately 20-80% equilibrium water content). RESULTS: Values of equilibrium water content measured with the Atago N-2E and those derived from the refractive index measurement with CLR 12-70 by the applications of sucrose-based models displayed a strong linear correlation (r2 = 0.978). The same correlations were obtained when the models are applied to obtain refractive index values from the Atago N-2E and compared with those (values) given by the CLR 12-70 (r2 = 0.978). No significantly different results are obtained between models derived from the whole range of the sucrose solution or the model limited to the normal range of soft contact lens hydration. CONCLUSIONS: Present results will have implications for future experimental and clinical research regarding normal hydration and dehydration experiments with hydrogel polymers, and particularly in the field of contact lenses.

Biocompatible Materials↗

PubMed1994

Use of refractometry to identify opioid-containing solutions.

The purpose of this laboratory study was to assess the value of refractometry in identifying the contents of a variety of opioid-containing solutions. A hand-held refractometer was used to document the refraction produced by the undiluted contents of alfentanil, fentanyl, morphine, sufentanil ampoules and by solutions of Ringer's lactate, 0.9% saline, 3.3% dextrose in 0.3% saline, and distilled water. Each opioid was then serially diluted in serial 1:2, 1:4, and 1:8 dilutions in each of these solutions and the refractions of each determined. Based on this information, blinded identification of various diluted opioid solutions was attempted. Refractometer values for undiluted fentanyl and sufentanil were identical with those for distilled water. Those for undiluted alfentanil and morphine were almost identical with each other and with 1:2 and 1:4 dilutions of either drug in Ringer's lactate or 0.9% saline. We conclude that refractometry is an unreliable screening method to detect tampering with opioid solutions.

Alfentanil↗

PubMed2004

On the suitability of refractometry for the analysis of glucose in blood-derived fluids.

BACKGROUND: Refractometry is the determination of the optical refractive index of a substance or a mixture of substances. It is a very sensitive method for the detection and quantification of dissolved analytes, but it is incapable of distinguishing between different analytes. The aim of this investigation was to determine the principle suitability of refractometry for the quantification of glucose (blood sugar) in blood and various blood fluids which can readily be obtained for medical diagnosis, in particular blood plasma, blood serum, and their ultrafiltrates. METHODS AND RESULTS: After the oral intake of freshly dissolved alpha-glucose, the in vivo blood contents of the alpha and beta anomers of glucose were found to be in an at least approximate equilibrium at all times. This observation is a prerequisite for a refractometrical determination of glucose due to the fact that both molecule forms have different refractive index increments. An assessment of the glucose content in untreated blood fluids was not possible, since no suitable relationship to the refractive index was found, most probably due to the influence of the many other substances present in blood on this parameter. However, after removal of certain macromolecules by ultrafiltration, value pairs showed a high level of correlation, providing the nominal molecular weight limit (cut-off) of the ultrafilter used possessed a maximum of 300 kDa. Besides macromolecules, the osmolality of the fluids undergoing measurement also proved to be a considerable interfering factor, particularly when values were outside the normal physiological range between 285 and 293 mmol/L. CONCLUSIONS: If a clinical application of this method is to be contemplated it is imperative (1) that blood cells are separated and removed, (2) that macromolecules present in plasma or serum are removed, e.g. by ultrafiltration, and (3) that beyond the results presented the influence of all small molecules other than glucose on the overall refractive index be determined and included in the calculation of analysis results.

Adult↗

PubMed2005

Evaluation of five commercially available assays and measurement of serum total protein concentration via refractometry for the diagnosis of failure of passive transfer of immunity in foals.

OBJECTIVE: To determine and compare sensitivity, specificity, accuracy, and predictive values of measurement of serum total protein concentration by refractometry as well as 5 commercially available kits for the diagnosis of failure of passive transfer (FPT) of immunity in foals. DESIGN: Prospective study. ANIMALS: 65 foals with various medical problems and 35 clinically normal foals. PROCEDURE: IgG concentration in serum was assessed by use of zinc sulfate turbidity (assay C), glutaraldehyde coagulation (assay D), 2 semiquantitative immunoassays (assays F and G), and a quantitative immunoassay (assay H). Serum total protein concentration was assessed by refractometry. Radial immunodiffusion (assays A and B) was used as the reference method. RESULTS: For detection of IgG < 400 mg/dL, sensitivity of assay H (100%) was not significantly different from that of assays C, E, and G (88.9%). Specificity of assays H (96.0%) and G (95.8%) was significantly higher than that of assays C (79.4%) and E (78.1 %). For detection of IgG < 800 mg/dL, sensitivities of assays H (976%), D (92.9%), C (81.0%), and G (81.0%) were significantly higher than that of assay F (52.4%). Specificity of assays F (100%), G (94.7%), and H (82.8%) was significantly higher than that of assays C (56.9%) and D (58.6%). Serum total protein concentration < or = 4.5 g/dL was suggestive of FPT, whereas values > or = 6.0 g/dL indicated adequate IgG concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: Most assays were adequate as initial screening tests. However, their use as a definitive test would result in unnecessary treatment of foals with adequate IgG concentrations.

Animals↗

PubMedDate not supplied

A guide to performing basic manifest refractometry.

Refractometry provides the ophthalmologist with the prescription that has the most plus power with the best vision. This eliminates the need for the patient accommodating to achieve clear vision at distance. Flowcharts, of the refractometry process, help the refractionist use standard procedures to accurately arrive at the correct baseline prescription for the patient's refractive state. By using the patient's history of subjective complaints, past refractive corrections, and present visual needs, the ophthalmologist then can prescribe the final prescription.

Algorithms↗

PubMed2006

Refractometry for quality control of anesthetic drug mixtures.

Injectable anesthetic drugs used in rodents are often mixed and further diluted to increase the convenience and accuracy of dosing. We evaluated clinical refractometry as a simple and rapid method of quality control and mixing error detection of rodent anesthetic or analgesic mixtures. Dilutions of ketamine, xylazine, acepromazine, and buprenorphine were prepared with reagent-grade water to produce at least 4 concentration levels. The refraction of each concentration then was measured with a clinical refractometer and plotted against the percentage of stock concentration. The resulting graphs were linear and could be used to determine the concentration of single-drug dilutions or to predict the refraction of drug mixtures. We conclude that refractometry can be used to assess the concentration of dilutions of single drugs and can verify the mixing accuracy of drug combinations when the components of the mixture are known and fall within the detection range of the instrument.

Acepromazine↗

PubMed1982

Water in malignant tissue, measured by cell refractometry and nuclear magnetic resonance.

It has been known that tumour-bearing tissues often have a significantly higher water content than the normal tissues from which they have been derived. Most of the evidence suggesting this in recent years has been obtained from methods employing nuclear magnetic resonance (NMR), which, although undoubtedly indicative of hydration, cannot at present be precisely quantified. Furthermore it has not been possible by these means to determine whether this overall increase in the water content of the tissue is principally an increase in the extracellular fluid or whether the water content of the tumor cells and the cells immediately adjacent to the tumours increases also. In this investigation, which is the first of its kind, a combination of NMR and immersion refractometry techniques have been used to examine the water content of normal and tumour bearing tissues. NMR measurements were made on pieces of normal and tumour bearing tissue from rat livers: intact living cells were also isolated from these pieces and their refractive indices measured by immersion refractometry from which the water content of their cytoplasm was calculated. It was found that all the cells so measured obtained from hepatomas had more water in their cytoplasm (usually over 5% more water) than any of the cells from normal livers; and that normal-looking liver cells taken from the vicinity of hepatomas also all had more water in them than those of normal liver cells, although the differences in this case were less. These results were closely parallel to those obtained by NMR measurements. It is therefore concluded that an appreciable proportion of the increase in the water content of the tissue as a whole that occurs during carcinogenesis, must, in this tissue, be an increase in intracellular water.

Animals↗

PubMed2004

Enhancing interpretation of gastric residual volume by refractometry.

The traditional practice of gastric residual volumes (GRVs) is flawed in its design and conception, is poorly standardized in its technique, is an inaccurate measure of gastric emptying, and serves as an insensitive marker for regurgitation and aspiration. The refractive index of a solution (like an enteral formula) is a physical property of that solution, which is remarkably constant and reproducible under varying conditions of concentration, pH, and temperature. Refractometry may be performed quickly and easily at the bedside, requires only a small representative sample of aspirated solution, and provides valuable measurements that can be used to calculate both the true total volume of contents and the specific volume of formula remaining in the stomach. Refractometry complements the use of GRVs as a monitor for patients receiving enteral feeding and should improve the accuracy with which patients at risk for aspiration may be identified.

Journal Article↗

PubMed1979

[Refractometry after treating with atropine and cyclopentolat in childhood (author's transl)].

Using Rodenstock's Refraktometer refractometry was done on 314 hyperopic children (3--14 years) first after treating with Atropine and some weeks later after Cyclopentolat-hydrochlorid. 53,1% of them showed higher hyperopia after Atropine than after Cyclopentolat, the maximum in difference was 1,75 dptr. In another group of children with Cyclopentolat-treating the residual accommodation was determined by four different methods (Refactometer, Apparatus of Schober, Phoropter in a distance of 5,0 and 0,4 mtrs). The results show a minimum of accommodation 45 minutes after application of the drops under special conditions. These conditions are reported as well as a method of correction of hypermetropia due to the values of refractometry or residual accommodation.

Accommodation, Ocular↗