Impedance-based measuring method for hemodynamic parameters

• US 7,783,345 B2
• Filed: 04/07/2005
• Issued: 08/24/2010
• Est. Priority Date: 10/07/2002
• Status: Expired due to Fees

• Current Assignee: CNSystems Medizintechnik GmbH (CNSystems Medizintechnik AG)
• Original Assignee: CNSystems Medizintechnik GmbH (CNSystems Medizintechnik AG)
• Inventors: Skrabal, Falko, Fortin, Jürgen
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Gedeon; Brian T
• Application Number:
  US11/101,358
• Publication Number:
  US 20050177062A1
• Time in Patent Office: 1,965 Days
• Field of Search: 600/508, 600/509, 600/547, 600/536
• US Class Current: 600/547
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• 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 5/0537 Measuring body composition by impedance, e.g. tissue hydration or fat content
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287

Abstract

A method is provided for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters. According to the method, an alternating measuring current of at least one frequency is introduced into the body, and the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body.

Claims

1. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the impedance is sensed at the thorax close to the inferior and superior thoracic apertures for at least two different measuring lengths (L, L2, L3, L4, L5) of essentially the same body segment.

2. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the electrical current is introduced at or close to the upper body end, such as at the neck, head, arms, and the lower body end, such as at a leg or legs, and that the impedance is measured at the thorax and/or trunk for at least two different measuring lengths (L, L2, L3, L4, L5).

3. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the impedance of at least one lower extremity is sensed for at least two different measuring lengths (L, L2, L3, L4, L5) of essentially the same body segment.

4. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein additionally whole-body impedance between the lower and upper body end is measured.

5. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the length difference (d, d1, a, a1) between the two different measuring lengths is small compared to the length of the examined body part.

6. The method according to claim 5, wherein the ratio of the length of the examined body part to the length difference (d, d1, a, a1) is between 3:

1 and 30;

1.

7. The method according to claim 6, wherein the ratio of the length of the examined body part to the length difference (d, d1, a, a1) is approximately 10:

1.

8. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths ((L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein from the impedance values determined for different measuring lengths (L, L2, L3, L4, L5) between electrodes, an operational electrode measuring length (L0), which corresponds to the electrically operational length of the body segment, and optionally an operational electrode distance (d0) are calculated.

9. The method according to claim 8, wherein the electrically operational length of the body segment is calculated according to the formula L0=d/(Z02/Z01−

1), where d is the difference between the two electrode measuring lengths used for the measurement, Z02 is the impedance for the longer electrode measuring length, and Z01 is the impedance for the shorter electrode measuring length.

10. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body,

wherein the impedance is sensed at the thorax close to the inferior and superior thoracic apertures for at least two different measuring lengths (L, L2, L3, L4, L5) of essentially the same body segment, and

wherein voltage electrodes at the inferior thoracic aperture are provided as double electrodes on the left and right side, respectively, of the thorax, wherein electrodes positioned at the same distance in the longitudinal direction are electrically connected to each other.

11. The method according to claim 10, wherein the electrodes on the left and right side, respectively, of the thoracic aperture may selectively be switched off.

12. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, wherein the electrical current is introduced at or close to the upper body end, such as at the neck, head, arms, and the lower body end, such as at a leg or legs, and that the impedance is measured at the thorax and/or trunk for at least two different measuring lengths (L, L2, L3, L4, L5), and

wherein measuring electrodes at the lower end of the trunk are provided as double electrodes on the left and right side, respectively, of the lower end of the trunk, wherein electrodes positioned at the same distance in the longitudinal direction are electrically connected to each other.

13. The method according to claim 12, wherein the electrodes on the left and right side, respectively, of the lower end of the trunk may selectively be switched off.

14. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein impedance variations with respect to time are measured at at least two frequencies.

15. The method according to claim 14, wherein the impedance is measured at three different frequencies.

16. The method according to claim 15, wherein the different frequencies are between 1 and 10 kHz, approximately 30 and 100 kHz, and above 200 kHz.

17. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein a maximum temporal variation of the measured impedance values (dZ/dt) is determined at at least two different measuring frequencies, and that the resistivity of the blood present in the body is determined therefrom.

18. The method according to claim 17, wherein the maximum temporal variation of the measured impedance value, especially in relatively small time frames, is determined at different times of the cardiac cycle.

19. The method according to claim 18, wherein the time frames are set at an abrupt rise of resistivity and at the time of minimum blood flow at the end of a diastole.

20. The method according to claim 18, wherein the time slots are put over the total cardiac cycle as small gliding slots.

21. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body,

wherein the impedance variations with respect to time are measured at at least two frequencies, and

wherein the frequency of the alternating measuring current is continuously varied from a lower measuring frequency to a higher measuring frequency.

22. The method according to claim 21, wherein the lower measuring frequency is approximately 1 kHz and the higher measuring frequency approximately 1000 kHz.

23. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body,

wherein the impedance variations with respect to time are measured at at least two frequencies, and

wherein the measuring current is impressed for at least another current electrode distance and at several different measuring frequencies, and that the impedance is measured for the different voltage measuring lengths and at the different frequencies.

24. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the phase angle between measuring current and measuring voltage is determined.

25. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein amplitudes, areas, and ascending or descending tangents of the impedance waves are used independently or together for calculating hemodynamic parameters.

26. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein empirical equations that have been determined by means of a gold standard including one of the Fick principle for stroke volume and e.g. echocardiography or isotope methods for other parameters, including as ejection fraction, pulmonal wedge pressure, diastolic function and the like, are used for measuring hemodynamic parameters.

27. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the sodium content in serum is determined and used in the calculation of relevant parameters.

28. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the sodium concentration in serum is mathematically estimated by the method and obtained as a result.

29. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein hormones, including one of ADH and natriuretic peptide, especially brain natriuretic peptide, and precursors thereof regulating body fluids, fractions and the composition thereof, are estimated by means of empirical equations and obtained as a result.

30. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein results of the measurements are sent to a central station in digital form by one of telephone and e-mail where the results are further processed and assessed, whereafter all necessary measures and therapy changes are transmitted to the patient from a remote place.

31. A non-invasive method for measuring the volume, the composition and the movement of electroconductive body fluids, based on the electrical impedance of the body or a body segment, especially for performing electromechanocardiography (ELMEC) or impedance cardiography (IKG) measurements for determining hemodynamic parameters,

wherein an alternating measuring current of at least one frequency is introduced into the body by means of measuring electrodes attached to the body surface,

wherein the impedance and temporal variations thereof of essentially the same body segment through which the alternating measuring current flows are measured for at least two different measuring lengths (L, L2, L3, L4, L5), essentially in the longitudinal direction of the body, and

wherein the body fluid is determined with its fractions, including extracellular space and intracellular space, and read out.