- To be trapped in a roller-coaster That ́s how some of the patients are describing the situa- tion of living with heart failure. To be stuck in their home not knowing if they will have to seek care today and not knowing if they will have the energy to attend that birth- day party later this week.Each year 2-3% of the Swedish population are diagnosed with heart failure, which results in 30,000 new individu- als with the disorder. Cardiovascular disease is rapidly in- creasing in the world and before 2030, people with heart failure will increased by 100%. Our improved living condi- tions and better health have allowed us to grow older and made us more dependent on other types of care, care at home. Today the patients are only looking for changes in weight and if they have excessive water in their body. What if we could see changes in values before they develop in to symptoms? We could then use a smaller dosage of medicine and minimize the risk of damaging other organs.During my work I have met with patients, husbands, wives and care givers to gain a better insight and understanding of the different stakeholders problems. The common factor is the insufficient methods for monitoring that are being used today, which aren’t optimal for patients, relatives or care givers.That led me to look at non-invasive testing methods (PPG), which would make it possible to see a trend of a patients health. Photoplethysmography (PPG) is a simple and low-cost optical technique that can be used to detect blood volume changes in the microvascular bed of tissue. PPG is most often employed non-invasively and operates at a red or a near infrared wavelength due to its properties to permeate tissue. By sending out different wavelengths and recorde how much is transmit- ted, scattered and absorb, the sensor can measure levels in the blood. When the station is done with the test it will send the result automatically to “Mina vårdkontakter” which will be accessible for both care givers and the patient. The profile will provide the patients with test results and a first contact holding advice for immediate and awaiting care. This will educate the patients and lead to them gaining a better understanding of their current health situation.

Complete blood count (CBC) analysis, often provided by an automated hematology analyzer, is a fundamental diagnostic test for evaluating a patient’s overall health status as a tool in diagnosing various medical conditions. CBC provides insights into the composition of the blood cells with parameters such as Mean Corpuscular Volume (MCV) and Hemoglobin (HGB). MCV represents the average size and volume of red blood cells, while HGB indicates the oxygen-carrying capacity of the blood. Different technologies are used in hematology analyzers, such as the impedance method and spectrophotometry, to achieve precise measurements of MCV and HGB. However, exploring other methodologies is of interest to potentially reduce instrument complexity and cost. Flow cytometry, based on light scatter, provides detailed information on the characteristics of individual cells and is commonly used in CBC analysis to differentiate white blood cells and reticulocytes. However, while the potential of this method for investigating MCV and HGB levels is well established, it is of significant interest to determine if the measurement techniques can be streamlined from three to one by solely using flow cytometry in this prototype analyzer. In this thesis, the possible use of measuring MCV and HGB using a flow cytometry system based on optical scatter data from a prototype hematology analyzer has been examined. The need to sphere the red blood cells before the measurements have also been investigated to evaluate reagent needs. The results have been evaluated based on the correlation factor, accuracy and precision of the proposed optical method. It is shown that the optical method in this thesis, can be used to measure MCV and HGB. However, the necessity of sphering the cells remains. Furthermore, a comparison is made between the optical method and the Sysmex XN-1000 to evaluate the accuracy of the obtained values. Finally, possible improvements and future work are suggested. / Blodstatus, utförd av automatiserade hematologiinstrument, är ett grundlägggande diagnostiskt test för att utvärdera en patients allmänna hälsotillstånd som ett verktyg för att diagnostisera olika medicinska tillsånd. Blodstatus ger inblick i blodets sammansättning med parameterar som Medelvolym av röda blodkroppar (MCV) och Hemoglobin (HGB). MCV representerar den genomsnittliga storleken och volymen av röda blodkroppar, medan HGB indikerar blodets syrebärande förmåga. Olika metoder används i hematologiinstrument, såsom impedansmetoden och spektrofotometri för att mäta MCV och HGB värden. Undersökning med hjälp av andra metoder för mätning av dessa parameter är dock utav intresse för att potentiellt minska instrument komplexitet och kostnader. Flödescytometri, baserad på ljusspridning, ger detaljerad information om egenskaperna hos enskilda celler och används ofta för att differentiera vita blodkroppar och reticulocyter. Även om potentialen att undersöka MCV- och HGB-nivåer med denna metod redan är väletablerad, är det av betydande intresse att undersöka om man kan minska mätmetoderna från tre till en, genom att enbart använda flödescytometri i detta prototypinstrument. I detta examensarbete har möjligheten att mäta MCV och HGB med hjälp av flödescytometri baserat på optisk spridningsdata från en prototyp hematologiinstrument undersökts. Behovet av att ”sfära” de röda blodkropparna innan mätningarna har också undersökts för att utvärdera reagensbehov. Resultaten har utvärderats utifrån den förslagna optiska metodens korrelationsfaktor, noggrannhet och precision. Resultatet visar att den optiska metoden som presenteras i denna uppsats, kan användas för att mäta MCV och HGB. Dock kvarstår behovet av att ”sfära” cellerna. Dessutom görs en jämförelse mellan den optiska metoden och Sysmex XN-1000 för att utvärdera noggrannheten hos de erhållna värdena. Till sist ges förslag på möjliga förbättringar och vidareutveckling av den optiska metoden för framtiden.