METHOD AND SYSTEM FOR MONITORING INTERNAL ELECTRICAL IMPEDANCE OF A BIOLOGICAL OBJECT
20220233088 · 2022-07-28
Assignee
Inventors
Cpc classification
A61B5/085
HUMAN NECESSITIES
A61B5/053
HUMAN NECESSITIES
A61B5/7221
HUMAN NECESSITIES
A61B5/0537
HUMAN NECESSITIES
International classification
Abstract
Method and system for monitoring an internal electrical impedance of a biological object including Internal Thoracic Impedance (ITI) comprising placing two arrays of electrodes on opposite sides of the biological object, wherein each of said two arrays comprise three equally spaced electrodes; imposing an alternating electrical current between pairs of the electrodes and obtaining voltage signals representative of a voltage drop thereon, calculating two values of internal electrical impedance of the biological object corresponding to the uttermost electrodes of said two arrays of electrodes placed on the opposite sides of the biological object.
Claims
1. A method for multi-electrode monitoring of an internal electrical impedance of a biological object, the method comprising the steps of: i) placing a first array of electrodes on one side of the biological object and a second array of electrodes on an opposite side of the biological object, wherein each of said arrays comprises at least three spaced apart electrodes; ii) performing a plurality of measurements on different pairs of electrodes that comprise two or more opposite sides electrode pairs, wherein each of said measurements is performed on a different pair of said electrodes by applying an alternating electrical current between the electrodes of the pair and obtaining voltage signals representative of a voltage drop thereon; wherein each opposite sides electrode pair comprises an electrode of the first array and an electrode of the second array; iii) calculating, for each electrode (of the different pairs of electrodes), values of impedance(s) indicative of sums of electrode impedance and a skin-electrode contact impedance to provide multiple values; iv) wherein said calculating using a system of linear equations; v) comparing said calculated sums to each other, wherein a difference between sums, found by the comparing, that exceeds a predetermined threshold value is representative of a potential failure in at least one of said electrodes related to the sums; and vi) calculating an internal electrical impedance value of the biological object based on (a) measurements of at least two opposite sides electrode pairs of the two or more opposite sides electrode pairs, and (b) calculated sums for each electrode of the at least two opposite sides electrode pairs.
2. The method of claim 1 further comprising performing measurement sessions by repeating steps ii)-iv) when the result of the comparison exceeds the predetermined threshold value.
3. The method of claim 2 further comprising defining a correctness of one or more measurements obtained during the measurement sessions or a faultlessness of at least one of the electrodes based on said result of the comparing.
4. The method of claim 3 further comprising denying acceptance of the measurement sessions.
5. The method of claim 3 further comprising replacing any faulty electrode.
6. The method of claim 1 wherein said biological object includes a human body.
7. The method according to claim 1 wherein said predetermined threshold value is 150 Ohm.
8. The method according to claim 1 wherein said internal electrical impedance of the biological object includes an Internal Thoracic Impedance (ITI).
9. The method according to claim 8 wherein said alternating electrical current has a value from 0.5 to 5 mA.
10. The method of claim 9 wherein said alternating electrical current has a value from 1 to 2 mA.
11. The method according to claim 9 wherein said alternating electrical current has a frequency from 50 to 200 KHz.
12. The method of claim 9 wherein said alternating electrical current includes alternating current of any periodic waveform.
13. The method of claim 8 wherein a number of said applying is defined by number of combinations by said pairs of electrodes.
14. The method according to claim 1 wherein the two or more opposite sides electrode pairs comprises any combination between any electrode of the first array and any electrode of the second array.
15. The method according to claim 1 wherein the two or more opposite sides electrode pairs comprises only some of any combination between any electrode of the first array and any electrode of the second array.
16. The method according to claim 1 wherein the calculating of the internal electrical impedance value comprises averaging the measurements of the at least two opposite sides electrode pairs.
17. The method according to claim 1 wherein the calculating of the internal electrical impedance value comprises combining the measurements of the at least two opposite sides electrode pairs by using a pre-set algorithm.
18. The method according to claim 1 wherein biological object is a lung and wherein the calculating of the internal electrical impedance value comprises combining the measurements of the at least two opposite sides electrode pairs by using a pre-set algorithm.
19. The method according to claim 1 wherein a number of the linear equations is smaller than a number of the plurality of measurements.
20. The method according to claim 1 wherein the calculating using the system of linear equations is based on an assumption that internal impedances of equal-length paths within the biological object are equal to each other.
21. A method for multi-electrode monitoring of an internal electrical impedance of a biological object, the method comprising the steps of: i) placing a first array of electrodes on one side of the biological object and a second array of electrodes on an opposite side of the biological object, wherein each of said arrays comprises at least three spaced apart electrodes; ii) performing a plurality of measurements on different pairs of electrodes, wherein each of said measurements is performed on a different pair of said electrodes by applying an alternating electrical current between the electrodes of the pair and obtaining voltage signals representative of a voltage drop thereon; wherein the different pairs of electrodes comprise two or more opposite sides electrode pairs, each opposite sides electrode pair comprises an electrode of the first array and an electrode of the second array; iii) calculating, for each electrode of the different pairs of electrodes, a sum of electrode impedance and skin-electrode contact impedance to provide multiple sums; iv) comparing said sums to each other, wherein a result of the comparison exceeding a predetermined threshold value is representative of a potential failure in at least one of said electrodes; and v) calculating an internal electrical impedance value of the biological object based on (a) measurements related to a certain opposite sides electrode pair of the two or more opposite sides electrode pairs, and (b) calculated sums for each electrodes of certain opposite sides electron pair, wherein there is an inter-electrode space between electrodes of each of the two or more opposite sides electrode pairs, wherein the certain opposite sides electrode pair is associated with a longest inter-electrode space out of the inter-electrode spaces of the two or more opposite sides electrode pairs.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] In order to better understand the subject matter that is disclosed herein and to exemplify how it may be carried out in practice, embodiments will now be described, by way of non-limiting example only, with reference to the accompanying drawings, in which:
[0026]
[0027]
[0028]
[0029]
[0030]
[0031]
DETAILED DESCRIPTION OF EMBODIMENTS
[0032] Reference is made to
[0033] As shown in
[0034] Sets formed by electrodes placed on the same side of biological object 108 i.e. 101-103 or 104-106 forms “reference” circuits and sets formed by at least two electrodes of different group's forms measurement circuits. It should be noted that pre-determined sets of electrodes comprise at least two electrodes. Analog multiplexer 110 is capable to connect any desired combinations of electrodes 101-106 forming pre-determined sets.
[0035] Preferably each array comprises three equally spaced electrodes and are placed on opposite sides of the biological object, e.g. opposite sides of the thorax of a patient in case of impedance plethysmography (as illustrated specifically in
[0036] Current source 112 supplies alternative electrical current of substantially identical intensity, e.g. of about 0.5-5 mA between electrodes of any predetermined set.
[0037] For impedance plethysmography preferably, current from about 1 mA to about 2 mA at a frequency of between about 50 KHz and about 200 KHz is used. Current of about 1 mA most preferably could be used. The term “frequency”, as used herein, refers to the fundamental frequency of a periodic waveform, so that the scope of the present invention includes alternating current of any periodic waveform, for example square, saw, etc. waves, and not just sinusoidal alternating current.
[0038] A voltage drop V across the measurement and reference circuits is measured by voltage measurement unit 114 while imposing an alternative current between circuit's electrodes. Generally, voltage drop across the measurement circuits being indicative of (proportional) a total impedance of the biological object and voltage drop across the reference circuits being indicative of (proportional) skin-electrode impedance.
[0039] The inventors have found that for improving impedance plethysmography all possible sets each including only pair of electrodes (forming both measurement and reference circuits) could be used. In that case, number of sets (pairs) is defined by number of combinations by pairs of electrodes.
[0040] It is to be understood that the preferred embodiment of
[0041] Referring to
[0042] Using of plurality of measured impedances corresponding to measurement circuits performing measurements on different areas of lung could improve accuracy of measurements due to decreasing effect of possible local non-uniformities or anomalies such as bullae within the lungs. Hence, during ITI monitoring (for a long period) the measurements could be performed periodically with replacement of measuring electrodes. Some deviation in location of measuring electrodes could occur and in such cases local non-uniformities or anomalies such as bullae could cause sufficient variations of measurement results. Using a plurality of electrodes covering different areas of lung (with different current ways) and “averaging” obtained ITI measured results could reduce such negative effect caused by local non-uniformities or anomalies. In addition, multiple measurements used for calculating internal impedance(s) also could improve accuracy of obtained result.
[0043] Turning back to
[0044] Generally the impedance Z.sub.M of any measurement circuit formed by set of electrodes is the sum of the following impedances:
Z.sub.M=Z.sub.IN+Z.sub.A+Z.sub.B (A)
Where:
[0045] Z.sub.IN—the internal impedance of biological object (e.g. ITI);
[0046] Z.sub.A—“transition” impedance which includes the impedance of first electrode; the impedance of the skin-electrode contact of electrode; and skin impedance;
[0047] Z.sub.B—“transition” impedance which includes the impedance of second electrode; the impedance of the skin-electrode contact of electrode; and skin impedance.
[0048] On the other hand, the impedance of any reference circuit formed by set of electrodes is representative of “transition” impedances only, i.e. the sum of the following impedances:
Z.sub.R=Z.sub.A+Z.sub.B (B),
Where:
[0049] Z.sub.A—“transition” impedance which includes the impedance of first electrode; the impedance of the skin-electrode contact of electrode; and skin impedance;
[0050] Z.sub.B—“transition” impedance which includes the impedance of second electrode; the impedance of the skin-electrode contact of electrode; and skin impedance
[0051] Thus, internal impedance of biological object (e.g. ITI in our case) Z.sub.IN could be calculated using voltage drops across measurement and reference circuits based on effective electric circuitry illustrated in
[0052] Measurement and reference circuits of the present invention could be characterized by the following impedances:
[0053] Z.sub.1—impedance of electrode and skin-electrode contact of electrode 101;
[0054] Z.sub.2—impedance of electrode and skin-electrode contact of electrode 102;
[0055] Z.sub.3—impedance of electrode and skin-electrode contact of electrode 103;
[0056] Z.sub.11—impedance of electrode and skin-electrode contact of electrode 104;
[0057] Z.sub.12—impedance of electrode and skin-electrode contact of electrode 105;
[0058] Z.sub.13—impedance of electrode and skin-electrode contact of electrode 106;
[0059] Z.sub.4—skin impedance between electrode 101 and 102; Z.sub.5—skin impedance between electrode 102 and 103;
[0060] Z.sub.9—skin impedance between electrode 104 and 105;
[0061] And Z.sub.10—skin impedance between electrode 105 and 106.
[0062] Sets of electrodes forming measurement circuits could comprise from minimum two up to all electrodes of both groups of electrodes while sets of electrodes forming reference circuits could comprise from minimum two and up to all electrodes of one of the groups of electrodes.
[0063] In order to be able calculate plurality (at least two) internal impedances of biological object (e.g. ITI) appropriate number of measurements by should be performed.
[0064] Reference is made to
Z.sub.1+Z.sub.6+Z.sub.11=M.sub.1
Z.sub.1+Z.sub.4+Z.sub.2=M.sub.2
Z.sub.2+Z.sub.5+Z.sub.3=M.sub.3
Z.sub.1+Z.sub.4+Z.sub.4+Z.sub.3=M.sub.4
Z.sub.2+Z.sub.7+Z.sub.12=M.sub.5
Z.sub.3+Z.sub.8+Z.sub.13=M.sub.6
Z.sub.11+Z.sub.9+Z.sub.12=M.sub.7
Z.sub.12+Z.sub.10+Z.sub.13=M.sub.8
Z.sub.11+Z.sub.9+Z.sub.10+Z.sub.13=M.sub.9
Z.sub.1+Z.sub.14+Z.sub.12=M.sub.10
Z.sub.2+Z.sub.16+Z.sub.11=M.sub.11
Z.sub.2+Z.sub.15+Z.sub.13=M.sub.12
Z.sub.3+Z.sub.12+Z.sub.12=M.sub.13
Z.sub.1+Z.sub.19+Z.sub.13=M.sub.14
Z.sub.11+Z.sub.18+Z.sub.3=M.sub.15
[0065] Where in addition to impendences presented in
[0066] According to the present invention totally 19 values of impedances including impedances of electrodes and skin-electrode contacts and 9 internal impedances of biological object (e.g. ITI) (Z.sub.6, Z.sub.7, Z.sub.8, Z.sub.14, Z.sub.15, Z.sub.16, Z.sub.17, Z.sub.18 and Z.sub.19) could be obtained by solving a system of the above 15 linear equations corresponding to 15 measurement sessions. The following physical assumption should be applied in order to be able to get 19 values from 15 linear equations: Z.sub.6=Z.sub.7=Z.sub.8 and Z.sub.14=Z.sub.15=Z.sub.16=Z.sub.17.
[0067] In that case 19 values of impedances could be calculated as following:
Z.sub.1=(2M.sub.1+2M.sub.2+2M.sub.3−2M.sub.4−2M.sub.5+M.sub.10−M.sub.1):2
Z.sub.2=(M.sub.2+M.sub.3−M.sub.4):2
Z.sub.3=(2M.sub.3−M.sub.10+2M.sub.1+2M.sub.2+2M.sub.3−2M.sub.4−2M.sub.5−M.sub.11):2
Z.sub.4=(2M.sub.5−2M.sub.1−M.sub.2−3M.sub.3+3M.sub.4−M.sub.10+M.sub.11):2
Z.sub.5=(M.sub.10−2M.sub.1−3M.sub.2−M.sub.3+3M.sub.4+2M.sub.5+M.sub.11−2M.sub.13):2
Z.sub.6=Z.sub.7=Z.sub.8
Z.sub.7=(2M.sub.5−M.sub.2−M.sub.3+M.sub.4−M.sub.7−M.sub.8+M.sub.9):2
Z.sub.9=(2M.sub.5−M.sub.11+M.sub.10−2M.sub.1−M.sub.2−M.sub.3+M.sub.4−2M.sub.8+2M.sub.9):2
Z.sub.10=(2M.sub.5−2M.sub.7+2M.sub.9−2M.sub.12+M.sub.10−2M.sub.1−M.sub.2−M.sub.3+M.sub.4+M.sub.11):2
Z.sub.11=(M.sub.11−M.sub.10+2M.sub.1+M.sub.2+M.sub.3−M.sub.4−2M.sub.5+M.sub.7+M.sub.8−M.sub.9):2
Z.sub.12=(M.sub.7+M.sub.8−M.sub.9):2
Z.sub.13=(2M.sub.12−M.sub.10+M.sub.7+M.sub.8−M.sub.9+2M.sub.1+M.sub.2+M.sub.3−M.sub.4−2M.sub.5−M.sub.11):2
Z.sub.14=(M.sub.10−2M.sub.1−2M.sub.2−2M.sub.3+2M.sub.4+2M.sub.5+M.sub.11−M.sub.7−M.sub.9):2
Z.sub.14=Z.sub.15=Z.sub.16=Z.sub.17
Z.sub.18=(2M.sub.14−4M.sub.1−3M.sub.2−3M.sub.3+3M.sub.4+4M.sub.5+2M.sub.11−2M.sub.12−M.sub.7−M.sub.8+M.sub.9):2
Z.sub.19=(2M.sub.15+2M.sub.10−4M.sub.1−3M.sub.2−3M.sub.3+3M.sub.4+4M.sub.5−M.sub.7−M.sub.8+M.sub.9−2M.sub.13):2
[0068] Performing maximal possible number of measurements for multi-electrode (six—in the present example) system provides most efficient way of system operation.
[0069] Preferably, only values of internal impedances Z.sub.18 and Z.sub.19 corresponding to measurement circuits defined by “uttermost” opposite electrodes could be calculated and used for characterizing internal impedance of the biological object (e.g. ITI). Since the inter-electrodes space in that case covers maximum biological object (e.g. lung) tissue these measurements could be most representative of variations of liquid amount within the lung tissue.
[0070] Combing (e.g. averaging) of calculated values internal impedances Z.sub.18 and Z.sub.19 could sufficiently improve accuracy of measurements by further decreasing affecting of possible local non-uniformities or anomalies within the lungs.
[0071] The inventors have found that internal impedance of biological object Z.sub.18 and Z.sub.19 (lung in the present example) could be calculated based on assumption that ITI corresponding to measurement circuits with similar distance between electrodes have substantially the close values.
[0072] To this end, impedances Z.sub.6, Z.sub.7 and Z.sub.8 corresponding to measurement circuits comprising opposite electrodes, such as first outer electrodes 101-104, internal electrodes 102-105 and second outer electrodes 103-106 are considered as having substantially the same values:
Z.sub.6=Z.sub.7=Z.sub.8
[0073] Also internal impedances Z.sub.14, Z.sub.15, Z.sub.16 and Z.sub.17 are considered as having substantially the same values:
Z.sub.14=Z.sub.15=Z.sub.16=Z.sub.17
[0074] If lung tissue does not include heterogeneous structures and is homogenous on the pass of electromagnetic signals, internal impedances Z.sub.6, Z.sub.7, Z.sub.8 as well Z.sub.14, Z.sub.15, Z.sub.16, Z.sub.17 will have substantially equal values. In that case, accuracy of calculated internal impedances Z.sub.18 and Z.sub.19 will increase due to performing maximal possible number of measurements.
[0075] When lung tissue includes heterogeneous structures within the pass of electromagnetic signal between at least one pair of electrodes, there could be some difference between the values of internal impedances in at least one of the groups Z.sub.6, Z.sub.7, Z.sub.8 and Z.sub.14, Z.sub.15, Z.sub.16 Z.sub.17. In such case value of internal impedances used for calculating will be effectively “averaged” and effect of heterogeneous structures on calculated impedances Z.sub.18 and Z.sub.19 will be decrease.
[0076] According to another preferred embodiment, In order to provide even more accurate measurements, calculated values of Z.sub.18 and Z.sub.19 could be compared therebetween.
[0077] Since the measurements are performed on live non-static biological object, e.g. human patient, various parts of breath cycle, un-controlled movements etc. could cause substantial changes of measurement conditions. Such changes could affect obtained values of internal impedances and decrease accuracy of final calculated result. To this end, pre-set value of difference between Z.sub.18 and Z.sub.19 could be used for measurements verification. Such pre-set value typically could be selected not exceeding 3 Ohms.
[0078] In case when difference between values of Z.sub.18 and Z.sub.19 does not exceeded (is less) pre-set value such measurement session(s) will be accepted and calculated values Z.sub.18 and Z.sub.19 could be used for diagnostic purposes.
[0079] Additionally, averaging of calculated values Z.sub.18 and Z.sub.19 could be performed.
[0080] Contrary, in case when difference between values of Z.sub.18 and Z.sub.19 does increase pre-set value such measurement session(s) will be rejected or discarded. Further, measurement session(s) could be repeated till acceptable result will be obtained as described above.
[0081] Appropriate utility of control unit (e.g. control unit 306 of
[0082] The calculation of the actual impedance values of the skin-electrode contacts of electrodes 101 106 enables to carry out long-term monitoring of the electrical impedance of a biological object with compensation for skin-electrode resistance drifts, even when the impedance values of the skin-electrode contacts are substantially different.
[0083] Reference is made to
[0084] Data processing utility 308 could comprise appropriate SW and HW that is connectable to data-storage unit 310, data IOI 315 and optionally to alarm unit. These SW and HW provide operation of system 100 according to the method described above.
[0085] System 100 could be powered from external (e.g. AC) and/or internal (e.g. battery) sources by means of a power supply (not shown).
[0086] Voltage measurement unit 304 typically includes rectifier (not shown) for obtaining the absolute value of the signals representing the voltage drops and analog to digital A/D converter for converting analog signals to a digital form signal compatible with data processing utility 308.
[0087] When using a device according to the present invention, electrical source 300 is alternately connected to each of the electrical circuits formed by pre-determined sets of electrodes 101-106 shown in
[0088] Control unit 306 orders analog multiplexer (commutator) 302 to form pre-determined number and configurations of measurement and reference circuits, e.g. 15 for six-electrodes scheme with two-electrodes sets of electrodes.
[0089] After data-storage unit (memory) 310 has received data from each of electrical circuits, data processing utility 308 can calculate the internal impedances Z.sub.IN (values of Z.sub.18 and Z.sub.19) according to the method described above. Data processing utility 308 also could perform additional processing of multiple measurement results, e.g. comparison of values of Z.sub.18 and Z.sub.19 and their combining due to pre-set algorithm (averaging, weighing, etc.).
[0090] Preferably, when performing a monitoring of a biological object the process described above is carried out periodically, so that Data processing utility 308 can simultaneously calculate the values of the internal impedance Z.sub.IN as well as changes therein. The change in Z.sub.IN may be calculated, for example, as the difference between the last value and the initial or previously measured value(s) or as a percentage therefrom. The results of the calculations could be transmitted to data IOI interface 14 and displayed by internal or external display, to data-storage unit (memory) 310, and to optional alarm unit.
[0091] In the event that the value of Z.sub.IN has decreased below a critical value, and/or in the event that the change in Z.sub.IN has exceeded a critical value, the alarm could be activated.
[0092] Data-storage unit (memory) 310 may provide data for analysis during the monitoring period so as to monitor the progress of the disease.
[0093] Thus, the present invention provides an effective and reliable technique for measuring the internal electrical impedance of a biological object and specifically Transthoracic impedance which can be used for effective monitoring in time of lung liquid volume status.
[0094] Those skilled in the art will readily appreciate that various modifications and changes can be applied to the embodiments of the invention hereinbefore described without departing from its scope defined in and by the appended claims.