Optimized electrical bioimpedance measurements of abdominal wall on a porcine model for the continuous non-invasive asse
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Optimized electrical bioimpedance measurements of abdominal wall on a porcine model for the continuous non‑invasive assessment of intra‑abdominal pressure Marcelo David1 · Omer Amran1 · Aviad Peretz1 · Aviad Raviv1 · Francisco Pracca2,3 Received: 18 August 2019 / Accepted: 29 November 2019 © Springer Nature B.V. 2019
Abstract This work describes the optimization of electrical bioimpedance measurements for indirect intra-abdominal pressure (IAP) assessment. The experimental run was performed on a female Sus scrofa domesticus (domestic pig). Different values of IAP were induced by inflation of the abdominal cavity, using a trocar placed near the umbilicus over the linea alba. The whole experiment was run within 1 h of the subject being sacrificed. The abdominal wall thickness was measured at an IAP of 5 mmHg. An exponential trend linking between the bioimpedance values at 99.8 kHz and the IAP was found. Nonoptimized electrode placement presented a strongly reduced sensitivity to IAP changes above 7 mmHg. Upon optimization and placing the electrodes with a separation of about 3.6 times the measured abdominal wall thickness, the sensitivity for high IAP drastically increased, allowing continuous non-invasive monitoring of IAP, confirming the optimization method proposed in this work. Keywords Intra-abdominal pressure · Bioimpedance · Non-invasive
1 Introduction Intra-abdominal hypertension (IAH) affects at least one in every two patients in intensive-care units (ICU) [1]. IAH is defined as the pathological increment in the intra-abdominal pressure (IAP) and is directly associated with increased morbidity and mortality [1–4]. IAP above 10 mmHg affects blood flow and organ perfusion. When high IAP is prolonged, abdominal decompression, either surgical or nonsurgical [5–8], might be indicated. Thus, the importance of continuous monitoring of IAP in critical patients is evident [3, 4].
* Marcelo David [email protected] 1
Department of Electrical Engineering, Jerusalem College of Technology – Lev Academic Center, HaVaad HaLeumi 21, 9372115 Jerusalem, Israel
2
Department of Intensive Medicine, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
3
Núcleo de Ingeniería Biomédica, Universidad de la República, Montevideo, Uruguay
As for the continuous measurement of IAP, several techniques have been proposed [5]. Continuous direct measurement of IAP is intrinsically invasive. A system based on a solid microtransducer was proposed in 2007 by Pracca et al. [9]. Minimally invasive indirect measurements of IAP are performed using Kron’s intravesical catheter as published by Iberti [10] and Cheatham [11], which, in 2006, was officially recommended by the World Society of the Abdominal Compartment Syndrome, as the standard [12, 13]. Continuous indirect non-invasive monitoring of IAP based on bioimpedance measurements was previously proposed by our group [14, 15]. Firstly, we developed a numerical model of the bioimpedance of the abdominal wall [14] and verified it on a pi
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