A high accuracy broadband measurement system for time resolved complex bioimpedance measurements

Bioimpedance Analysis as Early Predictor for Clot Formation Inside a Blood-Perfused Test Chamber: Proof of Concept Using an In Vitro Test-Circuit

Clot formation inside a membrane oxygenator (MO) due to blood-to-foreign surface interaction represents a frequent complication during extracorporeal membrane oxygenation. Since current standard monitoring methods of coagulation status inside the MO fail to detect clot formation at an early stage, reliable sensors for early clot detection are in demand to reduce associated complications and adverse events. Bioimpedance analysis offers a monitoring concept by integrating sensor fibers into the MO. Herein, the feasibility of clot detection via bioimpedance analysis is evaluated. A custom-made test chamber with integrated titanium fibers acting as sensors was perfused with heparinized human whole blood in an in vitro test circuit until clot formation occurred. The clot detection capability of bioimpedance analysis was directly compared to the pressure difference across the test chamber (ΔP-TC), analogous to the measurement across MOs (ΔP-MO), the clinical gold standard for clot detection. We found that bioimpedance measurement increased significantly 8 min prior to a significant increase in ΔP-TC, indicating fulminant clot formation. Experiments without clot formation resulted in a lack of increase in bioimpedance or ΔP-TC. This study shows that clot detection via bioimpedance analysis under flow conditions in a blood-perfused test chamber is generally feasible, thus paving the way for further investigation.

A Multichannel Real-Time Bioimpedance Measurement Device for Pulse Wave Analysis

Pulse wave analysis is an important method used to gather information about the cardiovascular system. Instead of detecting the pulse wave via pressure sensors, bioimpedance measurements can be performed to acquire minuscule changes in the conductivity of the tissue, caused by the pulse wave. This work presents a microcontroller-based bioimpedance measurement system, which has the capability to acquire impedance measurements from up to four independent channels simultaneously. By combining a problem-specific analog measurement circuit with a 24 bits analog-to-digital converter, the system is capable of acquiring 1000 impedances per second with a signal-to-noise ratio in a range from 92 to 96 dB. For data storage and analysis, the digitized data are sent via universal serial bus to a host PC. A graphical user interface filters and plots the data of all channels in real-time. The performance of the system regarding measuring constant impedances, as well as impedance changes over time is demonstrated. Two different applications for pulse wave analysis via multichannel bioimpedance measurements are presented. Additionally, first measurement results from a human subject are shown to demonstrate the system's applicability of analyzing the pulse wave morphology as well as the aortic pulse wave velocity.

A Robust System for Longitudinal Knee Joint Edema and Blood Flow Assessment Based on Vector Bioimpedance Measurements

We present a robust vector bioimpedance measurement system for longitudinal knee joint health assessment, capable of acquiring high resolution static (slowly varying over the course of hours to days) and dynamic (rapidly varying on the order of milli-seconds) bioresistance and bioreactance signals. Occupying an area of 78×90 mm(2) and consuming 0.25 W when supplied with ±5 V, the front-end achieves a dynamic range of 345 Ω and noise floor of 0.018 mΩrms (resistive) and 0.055 mΩrms (reactive) within a bandwidth of 0.1-20 Hz. A microcontroller allows real-time calibration to minimize errors due to environmental variability (e.g., temperature) that can be experienced outside of lab environments, and enables data storage on a micro secure digital card. The acquired signals are then processed using customized physiology-driven algorithms to extract musculoskeletal (edema) and cardiovascular (local blood volume pulse) features from the knee joint. In a feasibility study, we found statistically significant differences between the injured and contralateral static knee impedance measures for two subjects with recent unilateral knee injury compared to seven controls. Specifically, the impedance was lower for the injured knees, supporting the physiological expectations for increased edema and damaged cell membranes. In a second feasibility study, we demonstrate the sensitivity of the dynamic impedance measures with a cold-pressor test, with a 20 mΩ decrease in the pulsatile resistance associated with increased downstream peripheral vascular resistance. The proposed system will serve as a foundation for future efforts aimed at quantifying joint health status continuously during normal daily life.