Electrodes in clinical chemistry

Dual Ion-Selective Membrane Deposited Ion-Sensitive Field-Effect Transistor Integrating a Whole Blood Processing Microchamber for In Situ Blood Ion Testing

Blood ion testing is one of the methods that is commonly used for monitoring the immune status and providing physiological information for disease diagnosis. However, traditional blood ion sensing methods often require well-trained operators to process the whole blood sample and perform the measurements using bulky instruments, making real-time and continuous blood ion sensing at the bedside difficult. To address the above issues, we proposed a dual ion-selective membrane deposited ion-sensitive field-effect transistor (DISM-ISFET) sensor integrating a microchamber to enable on-chip serum extraction and in situ Na⁺/K⁺ ion sensing. As a proof of concept, we sequentially dispensed NaCl and KCl solutions at various concentrations on the DISM-ISFET to find out the highest ion sensitivity and selectivity. Next, we also confirm the high red blood cell sedimentation and serum purity using a microchamber. Finally, we evaluated the system performance using nine clinical whole blood samples and compared their Na⁺/K⁺ ion-sensing results with a commercial pocket ion meter. To sum up, our results showed that a DISM-ISFET system can successfully extract 200 μL serum from 500 μL whole blood sample and simultaneously achieve Na⁺/K⁺ ion sensing. All the sample processes and measurements can be finished within 10 min in a single chip. We envision this compact and easy-to-use system can be potentially used for various medical environments requiring real-time and continuous blood ion monitoring, such as in a hemodialysis room, operation room, and intensive care unit.

Paper-Based Optode Devices (PODs) for Selective Quantification of Potassium in Biological Fluids

This paper describes the design, fabrication, and feasibility of paper-based optode devices (PODs) for sensing potassium selectively in biological fluids. PODs operate in exhaustive mode and integrate with a handheld, smartphone-connected optical reader. This integrated measuring system provides significant advantages over traditional optode membranes and other paper-based designs, by obtaining a linear optical response to potassium concentration via a simple, stackable design and by harnessing a smartphone to provide an easy-to-use interface, thus enabling remote monitoring of diseases.

Synthesis and utilization of Co3O4 doped carbon nanofiber for fabrication of hemoglobin-based electrochemical sensor

In this paper cobalt oxide (Co₃O₄) nanoparticles were mixed with polyacrylonitrile to prepare Co₃O₄ doped carbon nanofiber (CNF) composite by electrospinning and carbonization, which was further used to modify on carbon ionic liquid electrode (CILE). Hemoglobin (Hb) was immobilized on Co₃O₄-CNF/CILE surface with Nafion acted as the protective film to fabricate an electrochemical biosensor (Nafion/Hb/Co₃O₄-CNF/CILE). Electrochemical behavior of Hb on the electrode was investigated with a pair of quasi-reversible redox peak appeared on cyclic voltammogram and electrochemical parameters were calculated. Moreover, this biosensor had good analytical capabilities for electrocatalytic reduction of different substrates including trichloroacetic acid, potassium bromate and sodium nitrite with wider detection range from 40.0 to 260.0 mmol L^-1, 0.1 to 48.0 mmol L^-1 and 1.0 to 12.0 mmol L^-1 by cyclic voltammetry, respectively. The proposed method showed excellent anti-interferences ability with good selectivity and was successful used for quantitative detection of real samples, which displayed the potential applications to develop into a new analytical device.

Recent advances on developing 3rd generation enzyme electrode for biosensor applications

The electrochemical biosensor with enzyme as biorecognition element is traditionally pursued as an attractive research topic owing to their high commercial perspective in healthcare and environmental sectors. The research interest on the subject is sharply increased since the beginning of 21st century primarily, due to the concomitant increase in knowledge in the field of material science. The remarkable effects of many advance materials such as, conductive polymers and nanomaterials, were acknowledged in the developing efficient 3rd generation enzyme bioelectrodes which offer superior selectivity, sensitivity, reagent less detection, and label free fabrication of biosensors. The present review article compiles the major knowledge surfaced on the subject since its inception incorporating the key review and experimental papers published during the last decade which extensively cover the development on the redox enzyme based 3rd generation electrochemical biosensors. The tenet involved in the function of these direct electrochemistry based enzyme electrodes, their characterizations and various strategies reported so far for their development such as, nanofabrication, polymer based and reconstitution approaches are elucidated. In addition, the possible challenges and the future prospects in the development of efficient biosensors following this direct electrochemistry based principle are discussed. A comparative account on the design strategies and critical performance factors involved in the 3rd generation biosensors among some selected prominent works published on the subject during last decade have also been included in a tabular form for ready reference to the readers.

Disagreement between ion selective electrode direct and indirect sodium measurements: estimation of the problem in a tertiary referral hospital

PURPOSE

We estimated the proportion of indirect ion selective electrode (ISE) plasma sodium analyses in intensive care unit (ICU) and hospital wide, exhibiting important disagreement with direct ISE results in relation to abnormal plasma protein concentrations.

MATERIALS AND METHODS

Direct and indirect ISE plasma sodium measurements were performed on 346 clinical specimens selected to reflect low, normal, or high total protein concentrations. Important intermethod disagreement was defined as |4| mmol/L or higher. Results were extrapolated to a 3-month laboratory series of 48,033 indirect ISE assays, including 2877 samples from intensive care.

RESULTS

Intermethod sodium disagreement at |4| mmol/L or higher was predicted for 25% of ICU samples. Almost all (97%) occurred in hypoproteinemic samples where indirect tended to exceed direct ISE estimates. Hospital wide, such disagreement was projected to occur in 8% of samples, of which the majority (70%) were also hypoproteinemic.

CONCLUSIONS

Important disagreement between indirect and direct ISE sodium measurements may exist in up to 1 in 4 ICU specimens and 1 in 12 hospital-wide samples. The main problem is indirect ISE overestimation associated with hypoproteinemia, potentially leading to misclassifications of pseudohypernatremia and pseudonormonatremia. We recommend that hospital laboratories consider standardization using direct ISE sodium measurement.

Ion Selective Electrodes (ISEs) and interferences--a review

Ion Selective Electrodes (ISEs) are used to measure some of the most critical analytes on clinical laboratory and point-of-care analysers. These analytes which include Na(+), K(+), Cl(-), Ca(2+), Mg(2+) and Li(+) are used for rapid patient care decisions. Although the electrodes are very selective, they are not free of interferences. It is important for laboratories to have an understanding of the type and extent of interferences in order to avoid incorrect clinical decisions and treatment.

Harpin and hydrogen peroxide both initiate programmed cell death but have differential effects on defence gene expression in Arabidopsis suspension cultures

Programmed cell death is increasingly viewed as a key component of the hypersensitive disease resistance response of plants. The generation of reactive oxygen species (ROS) such as H2O2 triggers a cell death programme in Arabidopsis suspension cultures following challenge with the bacterial elicitor harpin. Both harpin and exogenous H2O2 initiate a cell death pathway that requires gene expression, and also act as signalling molecules to induce the expression of plant defence genes encoding enzymes such as phenylalanine ammonia-lyase (PAL), glutathione S-transferase (GST) and anthranilate synthase (ASA1), an enzyme of phytoalexin biosynthesis in Arabidopsis. H2O2 induces the expression of PAL1 and GST but not that of ASA1. Harpin initiates two signalling pathways, one leading to increased ROS generation and expression of PAL1 and GST mRNA, and another leading to increased GST and ASA1 expression, independent of H2O2.

Variable selectivity of the Hitachi chemistry analyzer chloride ion-selective electrode toward interfering ions

Chloride measurements by ion-selective electrodes are vulnerable to interference by anions such as iodide, thiocyanate, nitrate, and bromide. We have found that the degree of interference of these anions on the Hitachi chemistry analyzer chloride electrode varies from electrode to electrode and this variation can even occur within the same lot of membrane. This variation is not dependent upon the length of time the cartridge has been in the analyzer because no correlation existed between the usage time and the electrode response to interfering ions. Neither is this variation due to the deterioration of the electrode because all electrodes tested had calibration slopes within the manufacturer's specification. Our study, however, showed that even after repeated exposure to a plasma sample containing 2 mM thiocyanate, the chloride electrode was still able to accurately measure the chloride in plasma without thiocyanate, thus confirming that a carryover effect does not exist from a previous thiocyanate-containing sample.

Performance evaluation of ISFETs and other ISE sensors for whole blood ion assay

Performance evaluations of ion-selective field-effect transistors (ISFETs) have been carried out using both quality-control materials and whole arterial blood samples. Comparison of the results from these evaluations suggests that the whole blood evaluation may be more useful when assessing the value of particular sensors for clinical applications. The effect of outliers on the imprecision estimates is demonstrated for ISFETs and ISEs, both graphically and in the calculation of the estimates with and without the outliers present. Estimates of constant and proportional bias, against an alternative sensor, determined from the intercept and slope of the linear regression vary according to the regression method used. The bias estimates obtained for the K + ISFET against the Radiometer KNA1 using ordinary least squares regression are compared with the Deming/Mandel method and the three-group resistant line method of Tukey. The Thorn EMI ISFETs are demonstrated to have acceptable imprecision and only a small bias compared with direct ISE instruments for whole blood assay and can be considered suitable for incorporation into clinical instrumentation.

Comparison of potassium ISFETs with the Radiometer KNA1 and the Corning 902 ion selective electrode analysers for whole blood potassium ion estimation

Evaluation of the performance of potassium ion sensitive field effect transistors (K+ ISFETs), developed by Thorn EMI in a form suitable for mass production and for incorporation in 'near the patient' analysers, showed only very small constant and proportional biases against the Radiometer KNA1 and the Corning 902 for whole blood potassium ion estimation. Between batch imprecision tests with whole blood showed the K+ ISFET was comparable in performance to the Corning 902 but inferior to the Radiometer KNA1. The evaluation demonstrated that ISFET manufacturing technology has now reached a stage of development at which ISFETs should be considered seriously for use in clinical chemical analysers.

Pseudohyponatremia: a reappraisal

Pseudohyponatremia is a falsely low serum sodium measurement. It occurs in cases of extreme hyperlipidemia or hyperproteinemia when serum sodium is measured by some--but not all--laboratory methods. This article reviews the most common techniques for measuring serum sodium levels, explains why pseudohyponatremia occurs, and identifies specific situations in which pseudohyponatremia can lead to dangerous errors in patient management. The review describes the dramatic change in prevalence of the different laboratory methods for measuring serum sodium over the past decade, and emphasizes the need for clinicians to be familiar with the methods of their clinical laboratory in order to properly interpret a reported serum sodium determination. I offer recommendations for the rational use of the different laboratory methods in various clinical situations.