DEVICE AND METHOD FOR PROCESSING AND VISUALIZING DATA RELATING TO CARDIAC AND PULMONARY CIRCULATION, OBTAINED BY MEANS OF AN ELECTRICAL IMPEDANCE TOMOGRAPHY DEVICE

Abstract

A medical system (6000) includes an EIT module (30, 33, 8000), a ventilation module (7100), a dosing module (4), a data input module (50) and a control module (70). The control module (70) coordinates a breath-hold maneuver, which is carried out at the ventilation module (7100). The control module (70) coordinates a perfusion measurement and a data acquisition (50) of EIT data (3), which is carried out at the EIT module (30, 33, 8000). The control module (70) determines an indicator, which indicates a state of perfusion of the lungs, and makes this indicator of the state of perfusion of the lungs available.

Claims

1. A process for processing and visualizing electrical impedance tomography device data (EIT data) obtained by means of an electrical impedance tomography device in respect to a perfusion of the heart and lungs of a patient the process comprising the steps of providing a data set of pixels containing impedance signals, which represent a superimposition of cardiac-related signal components in regions of the lungs, in regions of the heart or in regions of the thorax with signal components, which represent the spread of a predefined quantity of fluid of an indicator solution in regions of the lungs, in regions of the heart or in regions of the thorax during a breath-hold phase, on the basis of the data obtained by means of the electrical impedance tomography device via a signal waveform located within an analysis period, providing a data set, which represents information concerning at least one cardiac function, determining a data set with cardiac-related impedance changes containing information that represents a pulse beat of the heart in regions of the lungs, in regions of the heart or in regions of the thorax on the basis of the data set of pixels and on the basis of the data set containing information concerning the at least one cardiac function, determining a data set, which indicates a relative distribution of a signal power or power density or a relative amplitude distribution of the cardiac-related impedance signals in a predefined frequency range, on the basis of the data set containing cardiac-related impedance changes with information that indicates the pulsatile activity of the heart, determining a data set, which indicates time or phase information of the cardiac activity in regions of the lungs, of the heart or of the thorax, on the basis of the data set containing cardiac-related impedance changes with information that indicates the pulsatile activity of the heart, in regions of the lungs, in regions of the heart or in regions of the thorax, determining two location-specific data sets classified according to an evaluation criterion on the basis of the data set that indicates the relative distribution of power or powder density or the amplitude distribution of the cardiac-related impedance signals and/or on the basis of the data set containing time or phase information, which indicates the cardiac activity in regions of the lungs, in regions of the heart or in regions of the thorax, wherein a data set of the two location-specific data sets indicates a subset in the data set of pixels with impedance signals, in which subset a blood volume flow is directed from the lungs to the heart and wherein an additional data set of the two location-specific data sets indicates a subset in the data set of pixels with impedance signals, in which a blood volume flow is directed from the heart to the lungs, determining and providing an indicator, which indicates a state of perfusion of the lungs on the basis of the two location-specific data sets and on the basis of the data set of pixels with impedance signals, and determining and providing a first control signal, which indicates the indicator indicating the state of perfusion of the lungs.

2. A process in accordance with claim 1, wherein a signal separation is carried out, in an additional step before or after the determination of the location-specific data sets, on the basis of the data set of pixels with impedance signals and/or on the basis of the two location-specific data sets, and two location-specific, flow-specific and perfusion-specific data sets are provided.

3. A process in accordance with claim 2, wherein a second control signal is determined and provided in an additional step on the basis of the two location-specific and flow- and perfusion-specific data sets.

4. A process in accordance with claim 1, wherein a blood volume flow through the lungs or a blood volume within the lungs is determined and provided in an additional step, after the determination of the data sets, as an indicator, which indicates the state of perfusion of the lungs, on the basis of the two location-specific data sets and of the data set of pixels with impedance signals.

5. A process in accordance with claim 1, wherein a blood volume flow through the lungs or a blood volume within the lungs is determined and provided in an additional step after the determination of the data sets as an indicator, which indicates the state of perfusion of the lungs, on the basis of the location-specific and flow- and perfusion-specific data sets.

6. A process in accordance with claim 4, wherein an additional control signal is determined and provided in an additional step on the basis of the indicator, which indicates the state of perfusion of the lungs, on the basis of the blood volume flow through the lungs or on the basis of the blood volume and on the basis of the data set of pixels.

7. A process in accordance with claim 4, wherein an additional control signal is determined and provided in an additional step on the basis of the indicator, which indicates the state of perfusion of the lungs, on the basis of the blood volume flow through the lungs or on the basis of the blood volume which indicates the state of perfusion of the lungs.

8. A process in accordance with claim 1, wherein before the determination of the data set with cardiac-related impedance changes, a common data set of ventilation-specific signals is provided with the data set of pixels, which represent the superimposition of cardiac-related signal components in regions of the lungs, of the heart or of the thorax with signal components, which represent the spread of the predefined quantity of liquid of an indicator solution, with ventilation-specific signals, and a signal separation is carried out from the common data set to provide the data set of pixels containing impedance signals.

9. A process in accordance with claim 1, wherein a comparison of the determined data set, which indicates a relative power distribution/amplitude of the cardiac-related impedance signals in a predefined frequency range, and the indicator, which indicates the state of perfusion of the lungs, is carried out in an additional step by means of at least one comparison value, wherein the at least one comparison value is formed as a single comparison value or from a combination or combinations of comparison values from a group of comparison values, wherein the group of comparison values has one or more of the following comparison values. a data set of the same patient, which was determined chronologically before the determined data set, an indicator of the same patient, which was determined chronologically before the determined indicator, a data set of another patient, which was determined chronologically before the determined data set, an indicator of another patient, which was determined chronologically before the determined indicator, a mean typical data set of a class of patients, and a mean typical indicator of a class of patients, wherein further control signal, which indicates information concerning the situation of the patient as a deviation of a current patient situation from a desired or normal situation, a classification of a ventilation situation, and a trend in the course of the disease, is determined and provided on the basis of the comparison.

10. A process in accordance with claim 1, wherein a visualization is carried out on the basis of the control signal with pieces of information concerning a local two-dimensional or three-dimensional position of the two location-specific data sets in the region of the heart, in the region of the lungs or in the region of the thorax in a front view or transverse view of the lungs or of the heart.

11. A process in accordance with claim 6, wherein the indicator, which indicates the state ofperfusion of the lungs and/or the blood volume flow and/or the blood volume, is outputted on the basis of the additional control signal in the form of numerical values, diagrams, in relation to comparison values or of a curve of a time curve.

12. A device for carrying out a process for processing and visualizing electrical impedance tomography data obtained by means of an electrical impedance tomography device in respect to the perfusion of the heart and lungs of a patient, the device comprising data input unit providing )a data set of pixels with impedance signals, which represent a superimposition of cardiac-related signal components, which represent the spread of a predefined quantity of liquid of an indicator solution in regions of the lungs, in regions of the heart or in regions of the thorax during a breath-hold phase, on the basis of the electrical impedance tomography data obtained by means of the electrical impedance tomography device (EIT) via a signal waveform located within an analysis period, and providing a data set, which represents information concerning at least one cardiac function, and a control module configured for: determining a data set with cardiac-related impedance changes with information that indicates a pulsatile activity of the heart, in regions of the lungs, in regions of the heart or in regions of the thorax, on the basis of the data set of pixels and on the basis of the data set containing information concerning the at least one cardiac function, determining a data set, which indicates a relative distribution of a signal power or power density or a relative amplitude distribution of the cardiac-related impedance signals in a predefined frequency range, on the basis of the data set with cardiac-related impedance changes with information that indicates the pulsatile activity of the heart, determining a data set, which indicates time or phase information of the cardiac activity in regions of the lungs, in regions of the heart or in regions of the thorax, on the basis of the data set with cardiac-related impedance changes with information that indicates the pulsatile activity of the heart, determining two location-specific data sets classified according to an evaluation criterion on the basis of the data set that indicates the relative distribution of power or power density or the amplitude distribution of the cardiac-related impedance signals and/or on the basis of the data set with time or phase information that indicates the cardiac activity in regions of the lungs, in regions of the heart or in regions of the thorax, wherein one data set of the two location-specific data sets indicates a subset in the data set of pixels with impedance signals, in which subset a blood volume flow is directed from the lungs to the heart, and wherein an additional data set of the two location-specific data sets indicates a subset in the data set of pixels with impedance signals, in which subset a blood volume flow is directed from the heart to the lungs, and determining and providing a control signal, which indicates an indicator which indicates a state of perfusion of the lungs on the basis of the two location-specific data sets and on the basis of the data set of pixels with impedance signals, and a data output unit configured for determining the first control signal, which indicates the indicator indicating the state of perfusion of the lungs, by means of the data output unit.

13. A system comprising an EIT module, a ventilation module, a dosing module, a data input module and a control module configured to initiate and coordinate a breath-hold maneuver at the ventilation module, initiate and coordinate an impedance measurement at the EIT module, coordinate a data acquisition of EIT data at the EIT module, determine an indicator, which indicates a state ofperfusion of the lungs, and determine and provide a first control signal, which indicates the indicator, which indicates the state of perfusion of the lungs.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0159] In the drawings:

[0160] FIG. 1 is a schematic view of a flow chart for the processing of data of an EIT device for determining a state of perfusion of the heart and lungs;

[0161] FIGS. 2a is a schematic view of an additional embodiment of the flow chart according to FIG. 1;

[0162] FIGS. 2b is a schematic view of an additional embodiment of the flow chart according to FIG. 1;

[0163] FIGS. 2c is a schematic view of an additional embodiment of the flow chart according to FIG. 1;

[0164] FIGS. 2d is a schematic view of an additional embodiment of the flow chart according to FIG. 1;

[0165] FIGS. 2e is a schematic view of an additional embodiment of the flow chart according to FIG. 1;

[0166] FIG. 3 is a schematic view of an arrangement of an EIT device with an electrode array and syringe pump at a patient; and

[0167] FIG. 4 is a schematic view of a medical system with an EIT device.

DESCRIPTION OF PREFERRED EMBODIMENTS

[0168] Referring to the drawings, FIG. 1 shows a flow chart, which shows the processing and the visualization of data obtained by means of an electrical impedance tomography device (EIT) in respect to the perfusion of the heart and lungs of a patient. The processing is shown on the basis of a sequence of steps 1, which begins with a start 100 and ends with a stop 999.

[0169] A data set of pixels 110 containing impedance signals, which contains a superimposition of cardiac-related signal components with signal components that represent the spread of a predefined quantity of liquid 55 (FIG. 3, FIG. 4) of an indicator solution, is provided in a first step 11. The data set of pixels 110 thus has data that represent a superimposition of cardiac-related signal components in regions of the lungs, of the heart or of the thorax with signal components that represent the spread of the quantity 55 (FIG. 3, FIG. 4) of the indicator solution in the regions of the lungs, of the heart or of the thorax. The spread of the quantity 55 (FIG. 3, FIG. 4) of the indicator solution results from the fact that the predefined quantity 55 of liquid of the indicator solution is injected into the bloodstream of the patient 35 (FIG. 3) during the detection of data 3 (FIG. 3) with an electrical impedance tomography device 30 (FIG. 3) on a patient 35 (FIG. 3). The injection of the quantity 55 of indicator solution by means of an invasive infusion feed 81, for example, in the form of a saline solution, may be administered via a central or peripheral venous catheter. As an alternative, administration via a lumen of a Swan-Ganz catheter is also possible. Typical access paths are blood vessels in the neck of the patient 35, for example, the internal jugular vein. If the data set of pixels 110 containing impedance signal is acquired during a period without breathing activity, be it inhalation or exhalation by the patient 35 (FIG. 3), no effects of breathing or ventilation are contained in the data set 110. In this case, the data set 110 thus contains no variation in the impedances or impedance differences, which would indicate the ventilation situation of the lungs of the patient 35 (FIG. 3). A duration without an effect of breathing or ventilation in the course of mechanical ventilation is typically brought about by means of a so-called breath-hold maneuver. The ventilation is controlled now for a predefined duration, either in a chronological relation to the inspiratory or expiratory pause of the ventilation, such that breathing gas does not flow either into the lungs of the patient or out of the lungs of the patient. The data set of pixels 110 containing impedance signals thus contains only the cardiac-related signal components as well as the signal components that are influenced by the spread of the quantity 55 (FIG. 3,

[0170] FIG. 4) of the indicator solution with the air circulation through the heart and lungs of the patient 35 (FIG. 3). The spread of the quantity 55 (FIG. 3, FIG. 4) of the indicator solution thus represents quasi a predefined maximum time frame of the observation/analysis period for the further processing of the data set of pixels 110 with impedance signals.

[0171] A data set 120, which represents information on at least one cardiac function, especially a heart rate, is provided in a step 12 following the first step 11. This data set 120 containing pieces of information concerning the cardiac function or the heart rate may have been obtained in different manners and is provided in this step 12. The information concerning at least one cardiac function can now be obtained as data information from a physiological monitor, from a monitor for monitoring the oxygen saturation (SpO.sub.2), from a device for measuring an electrocardiogram (EKG) or also from an electrical impedance tomography device (EIT). Pieces of information concerning this at least one cardiac function may also be provided by combinations of devices, for example, a combination of a ventilator with an electrical impedance tomography device or from an electrical impedance tomography device with functions for EKG and/or SpO.sub.2 measurement.

[0172] A data set containing cardiac-related impedance changes 200 (CRIC) is determined in a second step 21 on the basis of the data set of pixels 110 containing impedance signals and on the basis of the data set 120 containing pieces of information concerning the at least one cardiac function. The respective pulsatile activity of the heart is determined for this in each pixel of the data set 110 on pixels containing impedance signals.

[0173] A data set 301, which indicates a relative distribution of a signal power or a relative amplitude distribution of cardiac-related impedance signals in a predefined frequency range, is determined in a third step 31. The determination 31 of the data set 301 is carried out here on the basis of the data set 200 containing cardiac-related impedance changes (CRIC) with the pieces of information that indicate the pulsatile activity of the heart. The predefined frequency range is obtained here as a physiologically relevant range of frequencies, which characterize cardiac activities. Heart rates are typically in a range of about 40 beats per minute to 240 beats per minute and higher in case of a normal sinus rhythm. This corresponds to a spectral frequency range below 1 Hz up to 4 Hz. A determination 32 of a data set 302, which indicates time or phase information of the cardiac activity in regions of the lungs, of the heart or of the thorax, is carried out after the determination 31 of the data set 301 with the relative distribution of a signal power or with a relative amplitude distribution. This determination 32 of the data set containing time or phase information of the cardiac activity is carried out on the basis of the data set 200 containing cardiac-related impedance changes (CRIC), which contains pieces of information concerning the pulsatile activity of the heart. The data set 302 with the time or phase information contains information on subsets of the data set of pixels 110 with impedance signals, in which subsets inflows or outflows into or out of the lungs or outflows and inflows from and to the heart occur.

[0174] A determination of two location-specific data sets 401, 402 is carried out in a fourth step 41 on the basis of the data sets 301, 302. The data sets 301, which indicate the relative distribution of power or power density or the amplitude distribution of the cardiac-related impedance signals, and the data set 302 containing time or phase information of cardiac activities in the region of the lungs, are classified on the basis of an evaluation criterion 440. The data set 401, which indicates a subset in the set of pixels 110 with impedance signals, in which a blood volume flow is directed as a flow out of the lungs to the left heart, is obtained as a result of the classification. The data set 402, which indicates a subset in the data set of pixels 110 with impedance signal, in which a blood volume flow is directed as a flow from the right heart to the lungs, is obtained as an additional result of the classification. These two location-specific data sets 401, 402 thus describe regions of the lungs and/or heart, in which an exchange of blood between the lungs and the heart takes place. The two data sets 401, 402 are thus representative of locally definable regions, so-called regions of interest (ROI), which represent flows and flow directions in the exchange of blood between the heart and the lungs and can consequently be assigned to the so-called pulmonary circulation in the cardiovascular system of the lungs.

[0175] A first control signal 500, which indicates an indicator 3000 indicating a state of perfusion of the lungs, is determined and provided in a fifth step 51. The determination of the first control signal 500 is carried out here on the basis of the two location-specific data sets 401, 402 and on the basis of the data set of pixels 110 with impedance signals. The control signal 500 is suitable and intended for indicating the subsets 401, 402 in the data set of pixels 110 with impedance signals as a part of the data set of pixels 110 with impedance signals. The first control signal 500 is configured and intended to make possible a visualization on an element 99 of the display device 95 on a display device 95, which is schematically suggested with broken lines in this figure as an optional component. Additional optional components are shown in this FIG. 1. Thus, an element for visualizing a curve 99 as well as an element for visualizing a numerical value 99 are also shown as additional elements 99 and 99, respectively. The first control signal 500 is optionally sent to and/or provided for additional components in this FIG. 1. These optional components 901, 902, 902, 902 are connected with broken line in the drawings to the first control signal 500 by means of an interface 901. Network components (LAN) 902, network or data servers 902 as well as means for wireless data transmission 902 can be supplied with the first control signal by means of the interface 901. Provision of the data sets 401, 402 into a data network or network system is made possible in this manner in order to make it possible to display the pieces of information obtained by means of this data processing in respect to the state of perfusion and the flow conditions in the lungs and heart not only directly at the electrical impedance tomography device (EIT) 30 (FIG. 3), i.e., at the site at which the data are obtained, but to also make possible a transmission of the data to additional units in the data network, for example, in a hospital network.

[0176] FIGS. 2a through 2e show embodiments of the sequence 1 according to FIG. 1. These embodiments have additional steps, which may additionally or alternatively be integrated in the sequence 1 or additionally in parts. Identical elements in FIGS. 1 and 2a are designated by the same reference numbers in FIGS. 1 and 2a.

[0177] It is described in FIG. 2a that a signal separation is carried out on the basis of the data set of pixels 110 containing impedance signals and/or on the basis of the two location-specific data sets 401, 402 before or after the determination 41 of the location-specific data sets 401, 402. Two location-specific and flow- and perfusion-specific data sets 403, 404 are determined and provided as a result. Determination and provision of a second control signal 600 is carried out following this signal separation 42 in a further step 61 on the basis of the two location-specific and flow- and perfusion-specific data sets 403, 404.

[0178] These additional steps 42, 61 described in FIG. 2a are integrated into the sequence 1 according to FIG. 1, as is graphically suggested in FIG. 2a, after the fourth step 41 with the determination of the location-specific data sets 401, 402. Compared with FIG. 1, this determination of the two location-specific and flow- and perfusion-specific data sets 403, 404 has the advantage that the second control signal 600 can be used directly for the visualization 900, 900 (FIG. 1, FIG. 3, FIG. 4), without an inclusion of the data set of pixels 110 containing impedance signals being necessary for the output.

[0179] FIG. 2b shows an expansion of the sequence 1 according to FIG. 1 and likewise of the partial sequence in FIG. 2a. Identical elements in FIGS. 1, 2a as well as 2b are designated by the same reference numbers in FIGS. 1, 2a as well as 2b. The indicator 3000 determined for the state of perfusion of the lungs in sequence 1 of FIG. 1 is determined specifically in a step 43 after the determination 41 of the location-specific data sets 401, 402. Including the data set of pixels 110 with impedance signals, a blood volume flow PVF 3001 through the lungs is determined in step 43. Based on the blood volume flow PVF 3001, a blood volume (PBV) 3002 within the lungs is additionally determined in a further step 43 on the basis of the location-specific data sets 401, 402 and of the data set of pixels 110 containing impedance signals. The indicator 3000, which indicates the state of perfusion of the lungs, can thus be configured in the form of the blood volume flow PVF 3000, as well as also of the blood volume (PBV) 3002 and determined and provided in a further step 71 as a third control signal 700 on the basis of the indicator 3000, PVF 3001 as well as (PBV) 3002. These additional steps in FIG. 2b are integrated into the sequence 1 according to FIG. 1, and the provision 71 of the control signal 700 is suitable for a visualization 900, 900 (FIG. 1, FIG. 3, FIG. 4).

[0180] FIG. 2c shows an alternative embodiment of FIG. 2b. Identical elements in FIGS. 1, 2a, 2b, 2c are designated by the same reference numbers in FIGS. 1, 2a, 2b, 2c. Unlike in FIG. 2b, the two location-specific and flow- and perfusion-specific data sets 403, 404 are used in FIG. 2c in the determination 43 instead of the location-specific data sets 401, 402 to determine the blood volume flow PVF 3001 through the lungs or the blood volume (PBV) 3002 as the indicator 3000, which indicates the state of perfusion of the lungs. An alternative third control signal 700 is determined and provided in an additional step 71 on the basis of the indicator 3000, which indicates the state of perfusion of the lungs. The integration of the steps according to FIG. 2c is carried out in a comparable manner as is described in connection with FIG. 2b, with a possibility of connection to a visualization 900, 900 (FIG. 1, FIG. 3, FIG. 4).

[0181] An alternative embodiment of the data provision 11 (FIG. 1) of sequence 1 according to FIG. 1 is shown in FIG. 2d. Identical elements in FIG. 1 and in FIG. 2d are designated by the same reference numbers in FIG. 1 and FIG. 2d. Instead of a data set of pixels 110 containing impedance signals, which represent a superimposition of cardiac-related signal components in the lungs with signal components that represent the spread of the quantity 55 (FIG. 3, FIG. 4) of the indicator solution in regions of the lungs and of the thorax, a common data set of pixels 110 containing impedance signals is provided, which contains ventilation-specific signal components 130, which are based on effects of inhalation/exhalation in the lungs due to breathing or ventilation, in addition to the cardiac-related signal components and to the signal components due to the spread of the quantity 55 (FIG. 3, FIG. 4) of the indicator solution. This data set of pixels 110 is subjected for this to a signal separation in an additional signal processing 11 in a further additional step. This signal separation 11 is used to remove the ventilation-specific signals 130 from the data set 110. A data set of pixels 110, which represents the superimposition of cardiac-related signal components in regions of the lungs and of the heart or of the thorax with signal components that represent the spread of the predefined quantity of liquid 55 (FIG. 3, FIG. 4) of the indicator solution in regions of the lungs, of the heart or the thorax, is obtained, in turn, as a result of the signal separation 11. The integration of step 11 is carried out according to this FIG. 2d in sequence 1 of FIG. 1 as an additional step 11 or as part of the first step shown and described in FIG. 1 in sequence 1 with provision 11 of the data set of pixels 110 containing impedance signals.

[0182] FIG. 2e shows an additional, further processing of the signals and results of sequence 1 of FIG. 1, as well as additional embodiments according to FIGS. 2b as well as 2c. Identical elements in FIGS. 1, 2b, 2c, 2e are designated by the same reference numbers in FIGS. 1, 2b, 2c, 2e. The data sets determined in FIGS. 1, 2b, 2c, which indicates a relative power distribution/amplitude distribution of the cardiac-related impedance signals in a predefined frequency range, as well as the indicator 3000, which indicator indicates the state of perfusion of the lungs, are compared in a further step 81 with comparison values 301, 301, 301 of the relative power/amplitude distribution and/or also of the indicator 3000, 3000, 3000, 3001, 3001, 3001, 3002, 3002, 3002. The indices , , indicate different situations, in which the comparison values have been determined. The index designates a data set 301 as an indicator 3000, 3001, 3002 of the same patient. The index designates a data set 301 as an indicator 3000, 3001, 3002 of another patient. The index designates a typical data set 301 as an indicator 3000, 3001, 3002 of a class of patients. As a result of this comparison 81, a fourth control signal 800 is generated, which is provided for an output, for example, a visualization 900, 900 (FIG. 1, FIG. 3, FIG. 4) and can thus be used in connection with the sequence 1 of FIG. 1.

[0183] FIG. 3 shows a schematic view of an arrangement of an EIT system 8000 with an EIT device 30 and electrode array 33 with a plurality of electrodes E.sub.1, . . . E.sub.n in combination with a syringe pump 4 in a common embodiment as a medical system 6000. The medical system 6000 according to this FIG. 3 makes possible a common functionality for carrying out the process/method of visualization of data obtained by means of an electrical impedance tomography device (EIT) in respect to the perfusion of the heart and lungs of a patient according to sequence 1 according to FIG. 1. Identical elements in FIGS. 1, 2a, 2b, 2c, 2d, 2e, 3 are designated by the same reference numbers in FIGS. 1, 2a, 2b, 2c, 2d, 2e, 3. The electrode array 33 with the electrodes E.sub.1, . . . E.sub.n 33 is arranged on the upper body (thorax) of a patient 35. A measured data acquisition and feed unit 40 is configured to feed a signal, preferably an alternating current (current feed) or also an alternating voltage (voltage feed) at a respective pair of electrodes 33 in a measurement cycle. The voltage signals resulting from the alternating current feed (current feed) are acquired as signals at the other electrodes 33 by the measured value acquisition and feed unit 40 and are provided as EIT data 3 to the data input unit 50. In addition to the measured data acquisition, the syringe pump 4 is likewise arranged at the patient 35 via an infusion line 5 and a site for invasive infusion feed 81, configured, for example, as an access in the cervical region of the patient 35. The EIT data 3 provided are fed in the EIT device 30 to a control unit 70 via a data input unit 50. A memory 77, which is configured to store a program code, is provided in the control unit 70. The run of the program code is coordinated by a microcontroller arranged as an essential element in the control unit or by another embodiment of computing elements (FPGA, ASIC, P, C, GAL). The computing and control unit 70 is thus prepared and intended to coordinate the sequence of steps shown in FIGS. 1, 2a, 2b, 2c, 2d, 2e and to carry out the steps shown with comparison operations, computation operations, storage and data organization of the data sets, for example, of the data sets 200, 301, 302 (FIG. 1), 401, 402 (FIG. 2a), 403, 404 (FIG. 2b). The values determined by the control unit 70 are provided by means of a data output unit 90 as control signals 500 (FIG. 1), 600 (FIG. 2a), 700 (FIG. 2b), 700 (FIG. 2c), 800 (FIG. 2e) and results 3000 (FIG. 1), 3001, 3002 (FIGS. 2b, 2c) to a data output unit 90 and are visualized 900 on a display device 95. An alternative of a visualization 900 (FIG. 4) on an external display device 95 (FIG. 4) is shown in the embodiment of the medical system 6000 shown in FIG. 4. In addition to the visualization 900, additional elements 99, for example, operating elements 98, elements 99 for displaying numerical values or elements 99 for displaying time curves or curves, are also present on the display device 95.

[0184] The syringe pump interacts with the EIT device 30 as follows: A predefined quantity 55 (bolus) of an indicator solution is injected by the syringe pump 4 into the blood circulation of the patient 35 via the infusion line 5 and the site of the invasive infusion feed 81. This quantity 55 of indicator solution flows through the blood circulation of the patient 35 with the blood flow and then reaches the right atrium of the heart of the patient 35 with the oxygen-depleted blood having a high level of carbon dioxide. This quantity 55 of the indicator solution then enters from there the lungs of the patient 35 with the blood flow and then again the blood circulation back from the lungs with the blood having a high oxygen level and having been freed from carbon dioxide for supplying organs and muscles of the patient 35 with oxygen. The flow of the quantity 55 of the indicator solution through the lungs brings about a change in the conductivity as a measurement effect, which can be detected by means of the EIT device 30 and the associated electrode array 33 as a locally and chronologically significant change in the impedances in both a region 402 in the plane of the electrode array 33, into which region the quantity 55 of the indicator solution flows through the plane of the electrode array 33 with the blood flow from the heart into the lungs, and also in a region 401 in the plane of the electrode array 33, in which region the quantity 55 of the indicator solution flows back into the heart from the lungs with the blood flow from the lungs into the heart through the plane of the electrode array 33. The procedure described in FIG. 1 with the sequence 1 makes it possible, when it is carried out by the control unit 70, to determine these two regions (ROI, Regions of Interest) 401, 402 in the image visualization or visualization 900 of the EIT data 3, in which the quantity 55 of the indicator solution flows from the lungs into the heart (ROI A) and flows again out of the heart to the lungs (ROI B). These regions (ROI A, ROI B) correspond to the regions that are designated as location-specific data sets 402, 401 in FIG. 1 in sequence 1.

[0185] FIG. 4 shows a schematic visualization of a medical system 6000 with an EIT device. Identical elements in FIGS. 1, 2a, 2b, 2c, 2d, 2e, 3 and 4 are designated by the same references in FIGS. 1, 2a, 2b, 2c, 2d, 2e, 3, 4.

[0186] The medical system 6000 has as additional components, in addition to the components according to FIG. 3 with an EIT system 8000 with an EIT device 30 and infusion pump 4, a ventilator 7100, an EKG measuring device 7200, an SpO.sub.2 measuring device 7300, a visualizing device 7400, a patient management system 7500, an extracorporeal lung assist device 4000 in a data interaction among and with one another in a data network system 9000 (cloud).

[0187] The data network system 900 has telemetry components (WLAN, Bluetooth) 9001, memory (file server, hard drive memory, hard disk), central and decentralized computers (servers) 9002, switching and coordination units (router, switch) 9003, units 9004 (HUB) for level adjustment and level amplification. The devices 7100, 7200, 7300, 4000, 7400, 8000, 7500 and the components 9001, 9002, 9003, 9004 are connected in a medical system 6000 into a network 9005 in the data network system 9000 via data connections 9008. These data connections 9008 in the data network system 9000 are indicated by solid lines in this FIG. 4.

[0188] The EIT system 8000 is configured as is described in connection with FIG. 3. The EIT system 8000 thus comprises an EIT device 30 with control unit 70, data input unit 50, electrode array 33 with a number of electrodes E.sub.1, . . . E.sub.n 33 and an output unit 95 suitable for visualization 9000. A measured value acquisition unit 40 (FIG. 3) is arranged at or in the data input unit 50 for signal feed and signal acquisition as well as for preprocessing (amplification, filtering) of the signals of the electrodes 33. A data output unit 90 (FIG. 3) is arranged at or in the display device 95. The acquired signals enter the control unit 70 in the EIT device 30 via the data input unit 50 as EIT data 3 from the electrode array 33 with the plurality of electrodes 33. The EIT system 8000 with the components 30, 40, 50, 70, 90, 95 is shown in this FIG. 4 with an outer border in the form of a dash-dotted line.

[0189] Additional data connections 9006, 9007 are shown in the medical system 6000 in this FIG. 4. Thus, there are direct data connections 9006 in the medical system 6000 from the devices 7100, 7200, 7300, 4000, 7400 to the EIT system 8000 or the EIT device 30. These direct data connections 9006 to the EIT device 30 are indicated by broken lines in this FIG. 4. In addition, there are direct data connections 9007 from different components 7200, 7300, 4000 to the ventilator 7100 in the medical system 6000. These direct data connections 9007 to the ventilator 7100 are indicated by broken lines in this FIG. 4. Direct interactions between the EIT system 8000 and/or the ventilator 7100 and the other devices 7200, 7300, 4000 are possible via the direct data connections 9006, 9007 without the inclusion of the data network system 9000.

[0190] All components of the medical system 6000 can be caused to interact and coordinate with one another with the inclusion of the data network system 9000 via the data connections 9008. This coordination is preferably carried out by a central control unit 7000. This central control unit 7000 is shown in this FIG. 4 as a component of the EIT system 8000 connected to the EIT device or also as a part of the EIT device 30. The central control unit 7000 can coordinate the functionality described in connection with FIG. 3 with processing and visualization of EIT data 3 in respect to a state of perfusion of the heart and lungs. This coordination may take place such that the infusion pump 4 as well as the ventilator 7100 and additional components are coordinated by the central control unit 7000 such that the administration of the quantity 55 of indicator solution takes place with the control of the ventilator 7100 preferably during a special maneuver of the mechanical ventilation in a so-called breath-hold phase and EIT data 3 are at the same time acquired by means of the EIT device 30 over the period of the breath-hold phase as an observation/analysis period. The electrodes 33 of the electrode array 33 are arranged on the thorax 34 of a patient 35. The syringe pump 4 brings about the administration of the quantity 55 of the indicator solution via an infusion line 5 at a site of an invasive infusion feed 81, in agreement in this FIG. 4 with the view shown in FIG. 3 in the region of the neck or shoulder of the patient 35. The extracorporeal lung assist device 4000 is connected to the patient 35 by means of a blood circulation connection 4001, which is only suggested in this FIG. 4, in order to feed oxygen to the patient and to remove carbon dioxide from the blood circulation of the patient 35. The blood circulation connection 4002 of the extracorporeal lung assist device (ECLS, ECMO) 4000 is used to connect the blood circulation of the patient 35 to the extracorporeal lung assist device 4000, for example, through an invasive access (arterial/venous) in the region of the groin of the patient 35 or at other suitable locations on the body.

[0191] A possibility of interaction of the ventilator 7100 with the extracorporeal lung assist device 4000 can be configured such that the ventilator 7100 coordinates, on the one hand, the time at which the quantity 55 of indicator solution is administered with the configuration of the ventilation and ventilation maneuver (breath-hold phase) and also takes on the task of supplying the patient with oxygen from the ventilator 7100 during the duration of the breath-hold phase.

[0192] The network 9005 in the data network system 9000 is configured to exchange the data or instructions between the individual components 4000, 7100, 7200, 7300, 7400, 7500, 8000 physically (wired line connections, optical data connections, telemetric data connections) and in terms of data technology (transmission protocols, error management), and to organize the corresponding infrastructure with the components 9001, 9002, 9003, 9004 and data connection 9008. The data connections 9008 may take place both in a wireless manner telemetrically or in a wireless manner optically. The visualization device 7400 is present in the system 6000 as an additional or alternative display device 95 to the display device 95 present in the EIT device 30 and/or in the EIT system 8000. This alternative or additional display device 95 may be arranged, for example, in a monitoring room, in which the clinical staff receives a display of a large number of information and/or data of individual patients or of a plurality of patients and can thus use this information in respect to an assessments of health situations of individual patients and for a comprehensive monitoring of these patients.

[0193] The central control unit 7000 is shown in this FIG. 4 as an embodiment of the control unit 70 of the EIT system 8000 with the EIT device 30 of the display device 95 and with the data input device 50.

[0194] However, other embodiments with arrangement of the central control unit 7000 in the system 6000 with possibilities of data provision 11 (FIG. 1, FIG. 2d), possibilities of data processing 21, 31, 41, 51 (FIG. 1), 42, 61 (FIG. 2a), 43, 71 (FIG. 2b), 43, 71 (FIG. 2c), 81 (FIG. 2e) in the EIT system 8000, data network system 9000 or medical system 6000 are also covered in the sense of the present invention. Thus, the central control unit 7000 may also preferably be configured, for example, as a part of the ventilator 7100 or as a part of the data network system 9000, for example, on a suitable data server 9002 arranged specially for this purpose in this data network system 9000. This leads to the possibility that the processing for a visualization of EIT data 3 in respect to a state of perfusion of the heart and lungs, as well as the coordination of the syringe pump 4 and of the ventilator 7100 in respect to the administration of the quantity 55 of indicator solution and for the organization of special ventilation settings and breath-hold phases at the ventilator 7100 can be carried out from a location located outside the EIT system 8000, quasi by as switching station or remote assistance station. In addition, the integration of the visualization into the data network system 9000 offers the possibility of using special computing rules detached from the EIT device 30 or EIT system 8000 independently from the site of the measurement and to use them for the use in the assessment of the situation of the patient 35.

[0195] These are some of the advantages that arise in connection with the components 400, 7100, 7200, 7300, 7400, 7500, 8000, especially for the EIT system 8000 as a part in a data network system 9000, but they are described in this FIG. 4 only as an example and without a claim to completeness.

[0196] While specific embodiments of the invention have been shown and described in detail to illustrate the application of the principles of the invention, it will be understood that the invention may be embodied otherwise without departing from such principles.