Regular monitoring of pulmonary congestion in car-diogenic pulmonary edema (CPE) patients is neces-sary for its adequate management via pharmaceuti-cal treatment. It is well known that the development of CPE is accompanied with an increase in hema-tocrit, plasma protein concentration and colloid os-motic pressure due to the decrease in the plasma volume. In the present study the mean left and right lung resistivity values taken pre- and post treatment with diuretics using a hybrid bio-impedance electri-cal impedance tomography system were correlate to the measured changes in hematocrit level. A marginal significant correlation was found between the abso-lute mean lung resistivity and hematocrit levels (Pearson’s correlation coefficient of R = 0.4, p-value = 0.057). When the change in the mean lung resistivity of a patient was plotted vs. the change in hematocrit readout, a significant linear correlation was found (R = 0.7, p-value = 0.02). These results support the validity of the resistivity measurements using bio-impedance system in monitoring changes of pulmonary edema in CPE patients.
Guyton, A.C. (2007) Textbook of medical physiology. W.B. Saunders Company, Philadelphia.
Fromm, R.E. Jr, Varon, J., and Gibbs, L.R. (1995) Congestive heart failure and pulmonary edema for the emergency physician. Journal of Emergency Medicine, 13, 71-87. doi:10.1016/0736-4679(94)00125-1
Figueras, J., and Weil, M.H. (1977) Increases in plasma oncotic pressure during acute Cardiogenic pulmonary edema. Circulation, 55, 195-199.
Figueras, J., and Weil, M.H. (1978) Blood volume prior to and following treatment of acute Cardiogenic pulmonary edema. Circulation, 57, 349-355.
Jahnsen, T., Skovborg, F., Hansen, F., Larsen, J., Nordin, H., and Strom, T. (1983) Variations in blood viscosity in patients with acute Cardiogenic pulmonary oedema treated with frusemide. Scandinavian Journal of Clinical and Laboratory Investigation, 43, 297-300.
Zlochiver, S., Arad, M., Radai, M.M., Barak-Shinar, D., Krief, H., Engelman, T., Ben Yehuda, R., Adunsky, A., and Abboud, S. (2007) A portable bio-impedance system for monitoring lung resistivity. Medical Engineering and Physics, 29, 93-100. doi:10.1016/j.medengphy.2006.02.005
Zlochiver, S., Radai, M.M., Barak-Shinar, D., Ben Gal, T., Yaari, V., Strasberg, B., and Abboud, S. (2005) Monitoring lung resistivity changes in congestive heart failure patients using the bioimpedance technique. Congestive Heart Failure, 11, 289-293. doi:10.1111/j.1527-5299.2005.04459.x
Freimark, D., Arad, M., Sokolover, R., Zlochiver, S., and Abboud, S. (2007) Monitoring lung fluid content in CHF patients under intra-venous diuretics treatment using bio-impedance measurements. Physiological Measurement, 28, s269-s277. doi:10.1088/0967-3334/28/7/S20
Arad, M., Zlochiver, S., Davidson, T., Shovman, O., Shoenfeld, Y., Adunsky, A., and Abboud, S. (2009) Estimating pulmonary congestion in elderly patients using bio-impedance technique: correlation with clinical examination and X-ray results. Medical Engineering and Physics, 31, 959-963. doi:10.1016/j.medengphy.2009.05.008
Arad, M., Zlochiver, S., Davidson, T., Shoenfeld, Y., Adunsky, A., and Abboud, S. (2009) The detection of pleural effusion using a parametric EIT technique. Physiological Measurement, 30, 421-428. doi:10.1088/0967-3334/30/4/006
Schuller, D., Mitchell, J.P., Calandrino, F.S., and Schuster, D.P. (1991) Fluid balance during pulmonary edema. Chest, 100, 1068-1075. doi:10.1378/chest.100.4.1068
Brown, B.H., Flewelling, R., Griffiths, H., Harris, N.D., Leathard, A.D., Lu, L., Morice, A.H., Neufeld, G.R., Nopp, P., and Wang, W. (1996) EITS changes following oleic acid induced lung water. Physiological Measurement, 17, A117-A130. doi:10.1088/0967-3334/17/4A/016
Chakko, S., Woska, D., Martinez, H., de Marchena, E., Futterman, L., Kessler, K.M., and Myerberg, R.J. (1991) Clinical, radiographic and hemodynamic correlations in chronic congestive heart failure: conflicting results may lead to inappropriate care. American Journal of Medicine, 90, 353-359.
Liebman, P.R., Philips, E., Weisel, R., Ali, J., and Hechtman, H.B. (1978) Diagnostic value of the portable chest x-ray technic in pulmonary edema. American Journal of Surgery, 135, 604-604. doi:10.1016/0002-9610(78)90045-4
Gehlbach, B.K., and Geppert, E. (2004) The pulmonary manifestations of left heart failure. Chest, 125, 669-682. doi:10.1378/chest.125.2.669
Pomerantz, M., Baumgartner, R., Lauridson, J., and Eiseman, B. (1969) Transthoracic electrical impedance for the early detection of pulmonary edema. Surgery, 66, 260-268.
Pomerantz, M., Delgado, F., and Eiseman, B. (1970) Clinical evaluation of transthoracic electrical impedance as a guide to intrathoracic fluid volumes. Annals of Surgery, 171, 686-694. doi:10.1097/00000658-197005000-00007
Kubicek, W.G., Patterson, R.P., and Witsoe, D.A. (1970) Impedance cardiograph as a non-invasive method of monitoring cardiac function and other parameters of the cardiovascular system. Annals of the New York Academy of Sciences, 170, 724-732. doi:10.1111/j.1749-6632.1970.tb17735.x
Fein, A., Grossman, R.F., Jones, J.G., Goodman, P.C., and Murray, J.F. (1979) Evaluation of transthoracic electrical impedance in the diagnosis of pulmonary edema. Circulation, 60, 1156-1160.
Saunders, C.E. (1988) The use of transthoracic electrical bioimpedance in assessing thoracic fluid status in emergency department patients. American Journal of Emergency Medicine, 6, 337-340. doi:10.1016/0735-6757(88)90151-9
Charach, G., Rabinovich, P., Grosskopf, I., and Weintraub, M. (2001) Transthoracic monitoring of the impedance of the right lung in patients with cardiogenic pulmonary edema. Critical Care Medicine, 29, 1137-1144. doi:10.1097/00003246-200106000-00008
Greenberg, B.H., Hermann, D.D., Pranulis, M.F., Lazio, L., and Cloutier, D. (2000) Reproducibility of impedance cardiography hemodynamic measures in clinically stable heart failure patients. Congestive Heart Failure, 6, 74-80. doi:10.1111/j.1527-5299.2000.80140.x
Brown, B.H., Barber, D.C., and Seagar, A.D. (1985) Applied potential tomography: possible clinical applications. Clinical Physics and Physiological Measurement, 6, 109-121. doi:10.1088/0143-0815/6/2/002
Harris, N.D., Suggett, A.J., Barber, D.C., and Brown, B.H. (1987) Applications of applied potential tomography in respiratory medicine. Clinical Physics and Physiological Measurement, 8, 155-165. doi:10.1088/0143-0815/8/4A/020
Harris, N.D., Suggett, A.J., Barber, D.C., and Brown B.H. (1988) Applied potential tomography: a new technique for monitoring pulmonary function. Clinical Physics and Physiological Measurement, 9, 79-85.
Newell, J.C., Edic, P.M., Ren, X., Larson-Wiseman, J.L., and Danyleiko, M.D. (1996) Assessment of acute pulmonary edema in dogs by electrical impedance imaging. IEEE Transactions on Biomedical Engineering, 43, 133-138. doi:10.1109/10.481982
Frerichs, I., Hahn, G., Schroder, T., and Hellige, G. (1998) Electrical impedance tomography in monitoring experimental lung injury. Intensive Care Medicine, 24, 829- 836. doi:10.1007/s001340050673
Noble, T.J., Harris, N.D., Morice, A.H., Milnes, P., and Brown, B.H. (2000) Diuretic induced change in lung water assessed by electrical impedance tomography. Physiological Measurement, 21, 155-163. doi:10.1088/0967-3334/21/1/319
Lionheart, W.R. (2004) EIT reconstruction algorithms: pitfalls, challenges and recent developments. Physiological Measurement, 25, 125-142. doi:10.1088/0967-3334/25/1/021