Esophageal electrode array for electrical bioimpedance measurement

• US 4,836,214 A
• Filed: 12/01/1986
• Issued: 06/06/1989
• Est. Priority Date: 12/01/1986
• Status: Expired due to Fees

• Current Assignee: Cardiodynamics International Corporation (Fujifilm Holdings Corporation)
• Original Assignee: Cardiodynamics International Corporation (Fujifilm Holdings Corporation)
• Inventors: Sramek, Bohumir
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Sykes, Angela D.
• Application Number:
  US06/936,324
• Time in Patent Office: 918 Days
• Field of Search: 128/642, 128/693, 128/734, 128/780, 128/784, 128/786, 128/713, 128/691-692
• US Class Current: 600/506
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/285 Endotracheal, oesophageal or gastric probes

Abstract

An array of electrical bioimpedance electrodes are provided on a hollow, flexible tube that is insertable into the esophagus of a patient. Four electrodes are positioned on the outer wall of the tube. Four wires are run through the hollow center portion of the tube and are connected through the wall of the tube to a respective one of the four electrodes. The four wires are connectable to an electrical bioimpedance measurement device. Two of the electrodes are connected to a high frequency, low magnitude constant current source so that a current can be injected into the thorax of the patient between the two electrodes. The other two electrodes are connected to the sensing input of the electrical bioimpedance measurement device and detect a voltage induced in the thorax of the patient that varies in accordance with the electrical bioimpedance changes in the patient. The tube is positioned in the esophagus proximate to the descending thoracic aorta so that the primary source of electrical bioimpedance changes is the flow of blood in the descending thoracic aorta. The present invention is used to determine the cardiac output of the patient that results in the flow of blood in the descending thoracic aorta.

Claims

1. An electrode array for determining the cardiac output of a patient, said electrode array being insertable into the esophagus of the patient so that bioimpedance measurements relating to cardiac output can be made when said electrode array is inserted into the esophagus of a patient, said electrode array comprising:

flexible tube having a first end and second end, and having an outside surface, said outside surface having an outside diameter selected so that said flexible tube is easily insertable into esophagus of a patient;

at least first, second, third and fourth circumferential electrodes positioned on said outside surface of said tube and spaced apart from each other along the length of said tube, each said electrode having an outer surface, each said outer surface having an outside diameter at least as large as large as the inside diameter of said esophagus;

said second electrode and said third electrode positioned along the length of said flexible tube between said first electrode and said fourth electrode, said second electrode separated from said third electrode by a distance of at least a multiple of said outside diameter of said tube; and

first, second, third, and fourth wires connected to said first, second, third and fourth electrodes, respectively, said wires extending out of said second end of said flexible tube.

2. The electrode array as defined in claim 1, wherein said first wire and said fourth wire are connectable to a source of high frequency constant current so that said high frequency constant current is injectable into the body of said patient between said first and fourth electrodes, and said second and third wires are connectable to the input of a voltage detection circuit so that a voltage developed in said body in response to said high frequency constant current is conducted from said second and third electrodes to said voltage detection circuit.

3. The electrode array as defined in claim 1, wherein said first, second, third and fourth electrodes comprise stainless steel.

4. The electrode array as defined in claim 3, wherein said stainless steel of said first, second, third and fourth electrodes is formed as a mesh.

5. The electrode array as defined in claim 1, whereihn said tube has a hollow inner portion, and wherein said first, second, third and fourth wires pass through said hollow inner portion from said first, second, third and fourth electrodes, respectively, to and out of said second end of said tube.

6. An electrode array as defined in claim 1 wherein said outer surface of said flexible tube has substantially the same diameter as said outer surfaces of said electrodes.

7. An electrode array for determining the cardiac output of a patient, said electrode array being insertable into the esophagus of the patient so that bioimpedance measurement relating to cardiac output can be made when said electrode array is inserted into the esophagus of a patient, said electrode array comprising:

a flexible tube having a first end and a second end, and having an outside surface, said outside surface having an outside diameter selected so that said flexible tube is easily insertable into the esophagus of a patient;

at least first, second, third, and fourth circumferential electrodes positioned on said outside surface of said tube and spaced apart from each other along the length of said tube, each said electrode having an outer surface, each said outer surface having an outside diameter of approximately three-eighths of an inch to ensure contact with the inside surface of said esophagus;

said second electrode and said third electrode positioned along the length of said flexible tube between said first electrode and said fourth electrode, said second electrode separated from said third electrode by a distance of at least a multiple of said outside diameter of said tube; and

first, second, third, and fourth wires connected to said first, second, third and fourth electrodes, respectively, said wires extending out of said second end of said flexible tube.

8. An electrode array for determining the cardiac output of a patient, said electrode array being insertable into the esophagus of the patient so that bioimpedance measurements relating to cardiac output can be made when said electrode array is inserted into the esophagus of a patient, said electrode array comprising:

a flexible tube having a first end and a second end, and having an outside surface, said outside surface having an outside diameter selected so that said flexible tube is easily insertable into the esophagus of a patient;

at least first, second, third and fourth, circumferential electrodes positioned on said outside surface of said tube and spaced apart from each other along the length of said tube, each said electrode having an outer surface, each said outer surface having an outside diameter selected to ensure contact with the inside surface of said esophagus;

said second electrode and said third electrode positioned along the length of said flexible tube between said first electrode and said fourth electrode, said second electrode separated from said third electrode by a distance of at least a multiple of said outside diameter of said tube, wherein;

said first electrode and said fourth electrode are spaced apart by a distance selected to be greater than the distance between the diaphragm of said patient and the top of the aortic arch of said patient; and

,

said second electrode and said third electrode are spaced apart such that the distance between said electrode and said third electrode is less than the distance between the bottom of the aortic arch of the patient and the diaphragm of the patient; and

first, second, third, and fourth wires connected to said first, second, third and fourth electrodes, respectively, said wires extending out of said second end of said flexible tube.

9. An electrode array for determining the cardiac output of a patient, said electrode array being insertable into the esophagus of a patient, said electrode array comprising:

a flexible tube having a first end and a second end, and having an outside surface, said outside surface having an outside diameter selected so that said flexible tube is easily insertable into the esophagus of a patient and so that said outer surface makes substantial contact with the inner surface of said esophagus;

at least first, second, third and fourth electrodes disposed on said outside surface, wherein;

each said electrode has an outer surface, each said outer surface having an outside diameter selected to make contact with the inside surface of said esophagus;

said first electrode and said fourth electrode are spaced apart by a distance selected to be greater than the distance between the diaphragm of said patient and the top of the aortic arch of said patient; and

said second elcetrode and said third electrode are disposed between said first electrode and said fourth electrode and are spaced apart such that the distance between said second electrode and said third electrode is less than the distance between the bottom of the aortic arch of the patient and the diaphragm of the patient; and

first, second, third, and fourth wires electrically connected to said first, second, third, and fourth electrodes, respectively, said wires extending out of said second end of said flexible tube.

10. A method of measuring the cardiac output of a patient by the insertion of an electrode array into the esophagus of a patient, comprising the step of:

inserting a flexible tube into the esophagus of a patient, said flexible tube having first, second, third and fourth electrodes on the surface thereof;

positioning said first electrode below the highest position of the diaphragm of the patient;

positioning said second electrode above the highest position of the diaphragm of the patient, spaced apart from said first electrode;

positioning said third electrode below the aortic arch of said patient, spaced apart from said second electrode;

positioning said fourth elecrode above the aortic arch spaced apart from said third electrode;

applying a high frequency constant current to said first and fourth electrodes so that said current flows through the tissues of said patient between said first and fourth electrodes; and

detecting a voltage developed across said second and third electrodes caused by said current flowing in said tissues of said patient, said voltage varying in accordance with changes in the electrical bioimpedance of said tissues.