56 research outputs found
A meta-analysis of published studies concerning the validity of thoracic impedance cardiography
No full textOur aim was to provide a meta-analysis of the literature concerning the validation of thoracic impedance cardiography (TIC) and to explain variations in reported results from differences in the studies. One hundred fifty-four studies (164 Fisher's Z-transformed correlation coefficients) comparing measurements of cardiac output or related parameters from TIC and a reference method were analyzed. Papers were classified according to differences in TIC methodology, reference method, and subject characteristics. Pooling using the random-effects method yielded an overall correlation of r = 0.82 (95% confidence interval: 0.80-0.84). ANOVA revealed a significant influence of the reference method and the subject characteristics on the correlation coefficient. In cardiac patients, the correlation was significantly decreased. No influence of the applied TIC methodology was found. CONCLUSION: TIC might be useful for trend analysis of different groups of patients. However, since the reference method was of significant influence, differences between TIC and the reference method are incorrectly attributed to TIC alon
ORIGINAL ARTICLES Morphology and Function The Influence of Through-Plane Motion on Left Ventricular Volumes Measured by Magnetic Resonance Imaging: Implications for Image Acquisition and Analysis
No full textIn the evaluation of the left ventricular (LV) function using magnetic resonance imaging (MRI), a stack of parallel short-axis (SA) cine images is acquired that covers the whole LV. The aim of this study is to quantify the contribution to the LV volume parameters, provided by the most basal image plane that shows the LV wall only in end diastole (ED) but not in end systole (ES). In 57 healthy volunteers (31 men, mean body surface area 1.87 m'), a complete set of parallel SA images was acquired (10-mm slice distance) by breathhold segmented k-space cine MRI (7 k, lines per beat). Th
Anomalous Diffraction by arbitrarily oriented Ellipsoids: Applications in Ektacytometry
No full textAnomalous diffraction by an arbitrarily oriented ellipsoid with three different axes is derived. From the resulting expression the relationship between the shape of the ellipsoid and the intensity pattern is immediately evident: The axial ratio of the elliptical isointensity curve equals the axial ratio of the elliptical projected area of the ellipsoid. A comparison of anomalous diffraction with calculations performed with the T-matrix method reveals that the anomalous diffraction approximation is highly accurate for single ellipsoidal red blood cells. Application of the expression for anomalous diffraction by ellipsoids to a population of red blood cells shows that, even in a red-cell suspension as examined in an ektacytometer, the axial ratio of the isointensity curves is equal to the mean axial ratio of the red blood cells in the population. In ektacytometry this relationship between cell shape and intensity pattern is commonly assumed to hold true without reference to the light-scattering properties of the cells. The results presented here show that this assumption is valid, and we offer a profound theoretical basis for it by considering in detail the light scattering by the red blood cell
The influence of extravascular lung water on cardiac output measurements using thoracic impedance cardiography
No full textThe purpose of this study was to investigate the influence of pulmonary oedema as measured with the double indicator dilution technique on the accuracy of cardiac output (CO) measurement using thoracic impedance cardiography (TIC) compared with thermodilution in thirteen sepsis patients. Differences in the Kubicek and Sramek-Bernstein equation with respect to pulmonary oedema were explored theoretically and experimentally. From a parallel two cylinder model a hypothesis can be derived that CO determined with the Kubicek equation is oedema independent, whereas CO determined using the Sramek-Bernstein equation is oedema dependent. Experimentally, CO determined using Kubicek's equation correlated better with thermodilution CO (r = 0.75) than CO determined with the Sramek-Bernstein equation (r = 0.25). The effect of oedema on the accuracy of TIC was investigated by comparing the differences in the CO of impedance and thermodilution to the extravascular lung water index. For the Kubicek equation the difference was not influenced by oedema (r = 0.04, p = 0.84), whereas for the Sramek-Bernstein equation the difference was affected by oedema (r = 0.39, p = 0.05). Thus, the effects of pulmonary oedema on the accuracy of TIC measurements can better be understood with the parallel cylinder model. Moreover, the Kubicek equation still holds when pulmonary oedema is present, in contrast to the Sramek-Bernstein equatio
Effects of flow pulsatility on platelet adhesion to subendothelium.
No full textPlatelet adhesion in the annular perfusion system developed by Baumgartner was studied under pulsatile, oscillatory, or steady flow conditions. To investigate in what way pulsatile flow affects platelet adhesion, we developed a flow system that produces a sinusoidal laminar flow superimposed on a constant component in the annular perfusion chamber. Frequencies and amplitudes of this sinusoidal flow were in the physiological range. Pulse frequencies varied between 30 and 120 beats/minute, and different amplitudes of the wall shear rate in the range 75 to 1000 s-1 were studied. Shear rates resulting from the constant flow component were between 500 s-1 and 1800 s-1. Under these conditions, no significant differences in platelet adhesion were observed between steady flow and pulsatile flow. In the case of an oscillatory flow (absence of constant component), a clear dependence of platelet adhesion on the amplitude of the pulse was seen. These data indicate that platelet adhesion in larger blood vessels, such as the aorta and larger arteries where backflow is limited, is not essentially influenced by the pulsatility in these vessels.</jats:p
Computer Controlled Laser Doppler Velocimeter for Measuring In Vitro Red Cell and Platelet Distributions
No full textEstimation of non-cardiogenic pulmonary oedema using dual-frequency electrical impedance
No full textThe study investigates the effects of non-cardiogenic oedema, especially the accumulation of protein in extracellular fluid, on thoracic impedance and proposes a new method of oedema measurement based on an impedance ratio from a dual-frequency measurement. In vitro measurements in a cell containing an albumin-in-saline solution yield a resistance increase when the albumin concentration increases. Subsequently, 13 patients having acute respiratory failure are measured. The single-frequency Z0 measurements and the proposed impedance ratio are compared with extravascular lung water (EVLW) determined by the double indicator dilution method. The single-frequency measurement correlates poorly with EVLW (r = -0.24, p = 0.56). In some patients, a total thoracic impedance increase is found with increasing EVLW. The correlation between the impedance ratio and EVLW is r = -0.79 (p <0.0005). The ratio decreases as EVLW increases. Thus, when oedema is measured using bio-impedance, cardiogenic and non-cardiogenic oedema yield different results. It is well recognised that cardiogenic oedema decreases total thoracic impedance. In non-cardiogenic oedema, however, protein accumulation causes an impedance increase. The decrease in the impedance ratio as EVLW increases can be explained by the accumulation of albumin in the extracellular compartmen
Validity and repronducibility of electrical impedance tomography for measurement of calf blood flow in healthy subjects
No full textThe Sheffield electrical impedance tomography; (EIT) system produces images of changes in the distribution of resistivity within tissue. The paper reports on the application of electrical impedance tomography in monitoring volume changes in the limb during venous occlusion. The aim of the study is to assess the feasibility, reproducibility and validity of calf blood flow measurements by EIT. In 14 healthy volunteers calf blood flow is compared, as determined in a calf segment by strain-gauge plethysmography (SGP), with the impedance changes measured by EIT during rest and post-ischaemic hyperaemia. The measurements are repeated to assess reproducibility. The reproducibility for the EIT, assessed from the repeated measurements and expressed as a reproducibility coefficient, is 0.88 during rest and 0.89 during hyperaemia. The reproducibility coefficient for SGP data is 0.83 at rest and 0.67 during hyperaemia. Flow measurements, assessed by means of two methods, correlate well at rest (r = 0.89), but only moderately during hyperaemia (r = 0.51). The correlation coefficient for the pooled flow measurements is 0.98. It is concluded that EIT is a valid and reliable method for assessing blood flow in the limb. Possible applications of EIT in localising fluid changes are discusse
Dynamic shear stress in parallel-plate flow chambers
No full textAn in vitro model using a parallel-plate fluid flow chamber is supposed to simulate in vivo fluid shear stresses on various cell types exposed to dynamic fluid flow in their physiological environment. The metabolic response of cells in vitro is associated with the wall shear stress. However, parallel-plate flow chambers have not been characterized for dynamic fluid flow experiments. We use a dimensionless ratio h/λv, in determining the exact magnitude of the dynamic wall shear stress, with its oscillating components scaled by a shear factor T. It is shown that, in order to expose cells to predictable levels of dynamic fluid shear stress, two conditions have to be met: (1) h/λv<2, where h is the distance between the plates and λv is the viscous penetration depth; and (2) f0<fc/m, where the critical frequency fc is the upper threshold for this flow regime, m is the highest harmonic mode of the flow, and f0 is the fundamental frequency of fluid flow
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