Intrapleural Impedance Sensor Real-Time Tracking of Pneumothorax in a Porcine Model of Air Leak

DeArmond, Daniel T.; Das, Nitin A.; Restrepo, Carlos S.; Katona, Mitch A.; Johnson, Scott; Hernandez, Brian; Michalek, Joel E.

doi:10.1053/j.semtcvs.2019.10.004

Cited by 4 publications

(5 citation statements)

References 30 publications

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“…e above studies have found that mathematical analysis is conducive to understand the patients' conditions of emergency temporary cardiac pacing and clarify the Bioinorganic Chemistry and Applications relationship between various physical indicators. Such an analysis was used to establish a biological model of the heart block in the study of Cingolani et al [14] and real-time tracking of intrathoracic impedance sensors in the study of DeArmond et al [15]. Similarly, Carson and Tseng [16] performed regression analysis on various indicators of ECG of patients.…”

Section: Resultsmentioning

confidence: 99%

Evidence-Based Analysis of the Emergency Temporary Cardiac Pacing (Electrical Stimulation from Metal Wire Electrode)

Lin

Tan

et al. 2021

Bioinorganic Chemistry and Applications

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The patient’s Cr (creatinine), BUN (blood urea nitrogen), HBG (hemoglobin), VT (ventricular tachycardia), pacing frequency, puncture point, emergency to permanent pacing time, pacing current (mA), pacing threshold current (mA), and admission diagnosis data were collected. The data were subjected to frequency statistics, curve regression analysis, PLS regression analysis, adjustment analysis, chi-square test, ridge regression analysis, discriminant analysis, negative binomial regression analysis, Poisson regression analysis, and stepwise regression analysis. Some findings include the following: (1) Cr has a significant positive effect on HBG, and BUN has a significant negative effect on HBG. (2) VT has a negative correlation with age and a positive correlation with CK-MB and CK (creatinine kinase). (3) Myocarditis has a negative correlation with age and a significant positive correlation with CTnI (cardiac troponin I). (4) AST (aspartate transaminase) and ALT (alanine aminotransferase) have a significant positive impact on DDI (D-dimer), while CTnI has a significant negative impact on DDI. MYO (myoglobin) has no impact relationship to DDI. (5) ALT has a significant positive relationship with APTT (partial thromboplastin time). (6) Alb (albumin) and TBIL (total bilirubin) have a significant positive effect on PLT (platelet) count, while pro-BNP (B-type natriuretic peptide) and MYO have a significant negative effect on PLT. (7) CK has a significant positive effect on INR (international normalized ratio). (8) The relationship between sinus node dysfunction and VT significantly affect the pacing frequency (beats/minute). For third-degree atrioventricular block, different samples of sinus node dysfunction showed significant differences. (9) There is a significant positive correlation between pacing current (mA) and pacing threshold current (mA). (10) There was a significant positive correlation between perceived voltage (mV) and the time from emergency to permanent pacing. Admission diagnosis has a significant positive impact on the time from emergency to permanent pacing. The change (increase) in time from emergency to permanent pacing was 1.137-fold when an additional condition was diagnosed on admission.

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Section: Resultsmentioning

confidence: 99%

Evidence-Based Analysis of the Emergency Temporary Cardiac Pacing (Electrical Stimulation from Metal Wire Electrode)

Lin

Tan

et al. 2021

Bioinorganic Chemistry and Applications

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“…We recently described a sensor capable of detecting the loss of parietal-to-visceral pleural apposition continuously in real-time in the setting of active pleural air leak, a concern of thoracic surgeons after major pulmonary resection. 1 The sensor was based on introducing a biologically validated low electrical current over the surface of the lung via electrodes embedded in a chest tube. In the presence of pleural air leak, when chest tube suction was adequate to maintain pleural apposition, the electrodes remained in contact with the lung and current flowed with low, or “in-range,” electrical impedance.…”

mentioning

confidence: 99%

“…Pigs (n = 3) under general anesthesia had two 28 French chest tubes placed into the right pleural space. 1 The Institutional Animal Care and Use Committee approved this study. One chest tube directed posteriorly was connected to a thoracoscopy insufflation port to mimic pulmonary air leak.…”

mentioning

confidence: 99%

“…One chest tube directed posteriorly was connected to a thoracoscopy insufflation port to mimic pulmonary air leak. 1 The second tube was directed anterolaterally with 4 embedded atrial pacing wires contacting the lung. 1 The pacing wires were connected to a real-time electrical impedance measurement circuit previously designed by the study engineers.…”

mentioning

confidence: 99%

“…1 The second tube was directed anterolaterally with 4 embedded atrial pacing wires contacting the lung. 1 The pacing wires were connected to a real-time electrical impedance measurement circuit previously designed by the study engineers. 2 Impedance measurements by registering as either in-range or out-of-range identified pleural apposition status.…”

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confidence: 99%

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Toward a Next-Generation Digital Chest Tube

et al. 2021

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Chest tubes in patients who have undergone pulmonary resection with pleural air leak are painful, impair ventilatory mechanics, and increase hospital length of stay and costs. Despite these well-documented concerns, current protocols for chest tube management in this setting are not well supported by evidence. Excessive suction applied to chest tubes has been associated with prolonged air leak due to alveolar over-distension, and most practitioners intuit that suction should be minimized to the lowest level needed to maintain desired pleural apposition. Unfortunately, there is no evidence-based protocol for the establishment of minimal adequate suction. Digital suction devices in current clinical use can identify air leak resolution preventing the delay of chest tube removal but cannot guide suction minimization while an air leak persists. We recently described a monitor of lung expansion in a porcine model of pleural air leak that could detect loss of pleural apposition continuously in real-time based on electrical impedance readings obtained directly from the surface of the lung via chest tube-embedded electrodes. The value of the impedance signal was “in-range” when pleural apposition was present but became abruptly “out-of-range” when pneumothorax due to inadequate suction developed. These findings suggested that a digitally controlled suction pump system could be programmed to recognize the development of pneumothorax and automatically identify and set the minimum level of suction required to maintain pleural apposition. We present here preliminary proof of concept for this system.

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Chest Tubes as a Platform for Physiologic Monitoring

DeArmond

Das

2023

The Annals of Thoracic Surgery

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Intrapleural Impedance Sensor Real-Time Tracking of Pneumothorax in a Porcine Model of Air Leak

Cited by 4 publications

References 30 publications

Evidence-Based Analysis of the Emergency Temporary Cardiac Pacing (Electrical Stimulation from Metal Wire Electrode)

Evidence-Based Analysis of the Emergency Temporary Cardiac Pacing (Electrical Stimulation from Metal Wire Electrode)

Toward a Next-Generation Digital Chest Tube

Chest Tubes as a Platform for Physiologic Monitoring

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