Accuracy and reliability of noninvasive stroke volume monitoring via ECG-gated 3D electrical impedance tomography in healthy volunteers.

Details

Serval ID
serval:BIB_42E4363DEFEB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Accuracy and reliability of noninvasive stroke volume monitoring via ECG-gated 3D electrical impedance tomography in healthy volunteers.
Journal
PloS one
Author(s)
Braun F., Proença M., Adler A., Riedel T., Thiran J.P., Solà J.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
13
Number
1
Pages
e0191870
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Cardiac output (CO) and stroke volume (SV) are parameters of key clinical interest. Many techniques exist to measure CO and SV, but are either invasive or insufficiently accurate in clinical settings. Electrical impedance tomography (EIT) has been suggested as a noninvasive measure of SV, but inconsistent results have been reported. Our goal is to determine the accuracy and reliability of EIT-based SV measurements, and whether advanced image reconstruction approaches can help to improve the estimates. Data were collected on ten healthy volunteers undergoing postural changes and exercise. To overcome the sensitivity to heart displacement and thorax morphology reported in previous work, we used a 3D EIT configuration with 2 planes of 16 electrodes and subject-specific reconstruction models. Various EIT-derived SV estimates were compared to reference measurements derived from the oxygen uptake. Results revealed a dramatic impact of posture on the EIT images. Therefore, the analysis was restricted to measurements in supine position under controlled conditions (low noise and stable heart and lung regions). In these measurements, amplitudes of impedance changes in the heart and lung regions could successfully be derived from EIT using ECG gating. However, despite a subject-specific calibration the heart-related estimates showed an error of 0.0 ± 15.2 mL for absolute SV estimation. For trending of relative SV changes, a concordance rate of 80.9% and an angular error of -1.0 ± 23.0° were obtained. These performances are insufficient for most clinical uses. Similar conclusions were derived from lung-related estimates. Our findings indicate that the key difficulty in EIT-based SV monitoring is that purely amplitude-based features are strongly influenced by other factors (such as posture, electrode contact impedance and lung or heart conductivity). All the data of the present study are made publicly available for further investigations.

Keywords
Adult, Algorithms, Calibration, Electric Impedance, Electrocardiography/statistics & numerical data, Exercise/physiology, Female, Healthy Volunteers, Humans, Image Interpretation, Computer-Assisted, Image Processing, Computer-Assisted/statistics & numerical data, Imaging, Three-Dimensional/statistics & numerical data, Male, Posture/physiology, Reproducibility of Results, Stroke Volume/physiology, Tomography/instrumentation, Tomography/methods, Tomography/statistics & numerical data
Pubmed
Web of science
Open Access
Yes
Create date
01/02/2018 19:37
Last modification date
20/08/2019 13:45
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