Satoru Nebuya

Study of the optimum level of electrode placement for the evaluation of absolute lung resistivity with the Mk3.5 EIT system.

Inter-subject variability has caused the majority of previous electrical impedance tomography (EIT) techniques to focus on the derivation of relative or difference measures of in vivo tissue resistivity. Implicit in these techniques is the requirement for a reference or previously defined data set. This study assesses the accuracy and optimum electrode placement strategy for a recently developed method which estimates an absolute value of organ resistivity without recourse to a reference data set. Since this measurement of tissue resistivity is absolute, in Ohm metres, it should be possible to use EIT measurements for the objective diagnosis of lung diseases such as pulmonary oedema and emphysema. However, the stability and reproducibility of the method have not yet been investigated fully. To investigate these problems, this study used a Sheffield Mk3.5 system which was configured to operate with eight measurement electrodes. As a result of this study, the absolute resistivity measurement was found to be insensitive to the electrode level between 4 and 5 cm above the xiphoid process. The level of the electrode plane was varied between 2 cm and 7 cm above the xiphoid process. Absolute lung resistivity in 18 normal subjects (age 22.6 +/- 4.9, height 169.1 +/- 5.7 cm, weight 60.6 +/- 4.5 kg, body mass index 21.2 +/- 1.6: mean +/- standard deviation) was measured during both normal and deep breathing for 1 min. Three sets of measurements were made over a period of several days on each of nine of the normal male subjects. No significant differences in absolute lung resistivity were found, either during normal tidal breathing between the electrode levels of 4 and 5 cm (9.3 +/- 2.4 Omega m, 9.6 +/- 1.9 Omega m at 4 and 5 cm, respectively: mean +/- standard deviation) or during deep breathing between the electrode levels of 4 and 5 cm (10.9 +/- 2.9 Omega m and 11.1 +/- 2.3 Omega m, respectively: mean +/- standard deviation). However, the differences in absolute lung resistivity between normal and deep tidal breathing at the same electrode level are significant. No significant difference was found in the coefficient of variation between the electrode levels of 4 and 5 cm (9.5 +/- 3.6%, 8.5 +/- 3.2% at 4 and 5 cm, respectively: mean +/- standard deviation in individual subjects). Therefore, the electrode levels of 4 and 5 cm above the xiphoid process showed reasonable reliability in the measurement of absolute lung resistivity both among individuals and over time.

Indirect measurement of lung density and air volume from electrical impedance tomography (EIT) data

This paper describes a method for estimating lung density, air volume and changes in fluid content from a non-invasive measurement of the electrical resistivity of the lungs. Resistivity in Ω m was found by fitting measured electrical impedance tomography (EIT) data to a finite difference model of the thorax. Lung density was determined by comparing the resistivity of the lungs, measured at a relatively high frequency, with values predicted from a published model of lung structure. Lung air volume can then be calculated if total lung weight is also known. Temporal changes in lung fluid content will produce proportional changes in lung density. The method was implemented on EIT data, collected using eight electrodes placed in a single plane around the thorax, from 46 adult male subjects and 36 adult female subjects. Mean lung densities (±SD) of 246 ± 67 and 239 ± 64 kg m(-3), respectively, were obtained. In seven adult male subjects estimates of 1.68 ± 0.30, 3.42 ± 0.49 and 4.40 ± 0.53 l in residual volume, functional residual capacity and vital capacity, respectively, were obtained. Sources of error are discussed. It is concluded that absolute differences in lung density of about 30% and changes over time of less than 30% should be detected using the current technology in normal subjects. These changes would result from approximately 300 ml increase in lung fluid. The method proposed could be used for non-invasive monitoring of total lung air and fluid content in normal subjects but needs to be assessed in patients with lung disease.

Estimation of the size of air emboli detectable by electrical impedance measurement

Non-invasive detection of air emboli in blood is investigated in vitro using a tetrapolar electrical impedance measurement. A cubic tank with a linear array of four electrodes, spaced approximately 1 cm apart down one side, was filled with 0.2 Sm−1 saline. Bubbles were generated by carbon dioxide gas. Electrical transfer impedance was measured every 8.2 ms at 1.25 MHz. The movement of bubbles was recorded by a video camera, and their sizes and depths from the middle of the array were measured using captured video images. Changes in transfer impedance caused by passage of bubbles were clearly observed and almost identical with those calculated theoretically. Using lead field theory and experimental results, the fundamental limit on the detectable size of bubbles was estimated at the carotid artery, the great saphenous vein and the cephalic vein. The theoretical results showed that a 0.5 mm diameter bubble is detectable at a depth of 5.3 mm, similar to the depth of the great saphenous and the cephalic veins, and a 2.3 mm diameter bubble is detectable at a depth of 21 mm, similar to the depth of the common carotid artery.

Detection of emboli in vessels using electrical impedance measurements—phantom and electrodes

A phantom was constructed to simulate the electrical properties of the neck. A range of possible electrode configurations was then examined in order to improve the sensitivity of the impedance measurement method for the in vivo detection of air emboli. The neck phantom consisted of simulated skin, fat and muscle layers made of agar and a conductive rubber tube mimicking the common carotid artery. The ring-shaped electrodes with a guard electrode showed the highest sensitivity to emboli at short distances.

Measurement of lung function using Electrical Impedance Tomography (EIT) during mechanical ventilation

The consistency of regional lung density measurements as estimated by Electrical Impedance Tomography (EIT), in eleven patients supported by a mechanical ventilator, was validated to verify the feasibility of its use in intensive care medicine. There were significant differences in regional lung densities between the normal lung and diseased lungs associated with pneumonia, atelectasis and pleural effusion (Steel-Dwass test, p < 0.05). Temporal changes in regional lung density of patients with atelectasis were observed to be in good agreement with the results of clinical diagnosis. These results indicate that it is feasible to obtain a quantitative value for regional lung density using EIT.

Accuracy of an optically isolated tetra-polar impedance measurement system

Accurate electrical transfer impedance measurement at the high frequencies (>1 MHz) required to characterise blood and intracellular structures is very difficult, owing to stray capacitances between lead wires. To solve this problem, an optically isolated measurement system has been developed using a phaselocked-loop technique for synchronisation between current injection (drive) and voltage measurement (receive) circuits. The synchronisation error between drive and receive circuits was less than 1 ns. The accuracy and reproducibility of the developed system was examined using a tissue equivalent Cole model consisting of two resistors and one capacitor. The absolute value Z and phase shift θ in impedance of the Cole model was measured at 1.25 MHz by both an LCR meter and the isolated measurement system. The difference between the values measured by the isolated measurement system and those measured by the LCR meter was less than 0.27 Ω (2.9%) in Z and 0.79 degree in θ. The standard deviation was less than 0.09Ω in Z and 0.60 degree in θ.

Temporal change in IL-6 mRNA and protein expression produced by cyclic stretching of human pulmonary artery endothelial cells

The time courses of interleukin (IL)-6 gene expression and protein production were examined in human pulmonary artery endothelial cells (HPAECs) subjected to cyclic stretching. IL-6 protein was increased even in cells without stretching. Fold changes determined by dividing the level of IL-6 protein in stretched cells by that in unstretched cells at the same sampling times indicated that IL-6 protein was increased by stretching. At least 1 h of stretching was necessary to elicit an increase of IL-6 protein, and the levels peaked at 3 h after the start of stretching. After withdrawal of stretching, there was no further increase of IL-6 protein. The expression levels of the IL-6 gene were significantly increased by stretching and peaked at 30 min after the start of stretching. The difference in the peak times of IL-6 gene and protein expression likely reflects the process of protein synthesis after the appearance of IL-6 mRNA.

Frequency characteristics of the electrical conductivity in normal and coagulated blood

The electrical conductivity and phase shift of normal and coagulated blood sampled from 10 pigs were measured using an LCR meter, Agilent 4285A. The hematocrit of normal blood was also measured. The conductivity difference between normal and coagulated blood remained at 4.3 mS/cm up to 800 kHz, and then gradually decreased. The conductivity difference was not correlated with the hematocrit (correlation coefficient = 0.04). The phase difference between normal and coagulated blood reached the maximum, -13.5 degree, between 1 and 2 MHz. Therefore, it is possible to discriminate thrombi from air emboli using the phase difference at the frequency range of 1 to 2 MHz.

Facilitation of motor evoked potentials in the anterior tibial muscle by repetitive subthreshold electrical stimulation.

Subthreshold electrical stimulation with an intensity less than the threshold for evoking M-waves is applied repetitively to the common peroneal nerve via surface electrodes. The stimulation intensity is varied by adjusting the pulse width from 0 to 240 μs, while the pulse interval (40 ms) and current amplitude are kept constant. Single magnetic stimuli are applied to the motor cortex using a circular coil. Motor evoked potentials are recorded from the anterior tibial muscle in six normal subjects for various subthreshold stimulation intensities. Signal processing (filtering in the time and frequency domains) removes the artifact caused by the subthreshold electrical stimulation from the motor evoked potential. Statistically significant motor evoked potential facilitation (p<0.05) is observed for pulse widths ranging from 72 to 240 μs in all the tested subjects. A pulse width corresponding to 90% of the electrical threshold facilitated the motor evoked potential in five of the six subjects.

Feasible monitoring methods for lung and circulatory functions using wearable sensors

Technology of electrical impedance measurement and electrical impedance tomography has been studied for several decades by our research group. In this paper, some applications of us were introduced in research fields as healthcare, psychology and intensive care.