BIO REACTANCE & BIO IMPEDENCE

Dr.Pratapa Reddy M.D.PDCC

YASHODA HOSPITAL
HI TECH CITY
• Disclaimer
• There is no personal interest or institutional interest in promoting any
commercial product and nothing is in favor any such activity
• No personal gain or financial contribution from the equipment side
• Everything is being done on volunteer basis with enthusiasm to
explore new ideology, technology and passing on the knowledge and
experience to future generations………………
• CARDIAC OUTPUT

• METHODS
• Dye dilution methods
• The Swan-Ganz catheter
• Bioimpedance
• Doppler ultrasound
• Pulse contour analysis
• NICO
• esCCO (pulse indexed)
• Continuous wave Doppler
• Pulse contour analysis
BIOIMPEDENCE
• Bioimpedance analysis is based on the principle that different tissues
in the body possess varying levels of electrical conductivity.
• Thoracic bioimpedance (TEB) is a non-invasive method of CO
monitoring
• used by astronauts in 1960s
• considering thorax as a cylinder perfused with fluid with specific
resistivity
• measures the electrical resistance of the thorax to a high
frequency, low amplitude current
• Electrodes six in number are placed (two on either side of neck and
four in lower thorax) on the patient and the resistance to current
flowing from the outermost to innermost electrodes is measured
• Stroke Volume Measurements
• Blood velocity component – sigman effect
• Time Relationships in the Cardiac Cycle
• the time difference between specific events in the cardiac cycle can be
studied
• time differences between the two signals can be interpreted as the time
difference between electrical and mechanical aspects of the cardiac activity
• BIOIMPEDENCE WORKS ON TIME DELAY
The rheocardiographic measurement of
thoracic electrical bioimpedance. The
external sensors (1 and 4) provide
alternating electrical current of high
frequency and low amperage. A current
with such properties is totally harmless for
the patient. The internal sensors (2 and 3)
measure the electrical bioimpedance. The
impedance measured is called baseline
thoracic bioimpedance (Zo). Because of the
pulsatile blood flow, the intra-aortic blood
volume and consequently the chest
bioimpedance are constantly changing. The
impedance is depicted in a waveform and
the stroke volume is estimated with
mathematical equations
Disadvantages of bioimpedence
• (a) the waveforms measured by an impedance cardiograph are affected not only by
the change of blood volume in the aorta but also by that in various organs such as
the heart and lungs.

• (b) the impedances measured by a pair of small electrodes separated by a short

distance give useful information about the region in the vicinity of the electrodes

• (c) much valuable information will be available, if the relationships between the
measurement results and the pulsatile blood flow are understood, and

• (d) by choosing an appropriate electrode arrangement, we may get much useful

information about the blood circulation in the organs
BIOREACTANCE – ELECTRODE
PLACEMENT