Internal thoracic impedance - a useful method for expedient detection and convenient monitoring of pleural effusion

Internal thoracic impedance - a useful method for expedient detection and convenient monitoring of pleural effusion

Measurement of internal thoracic impedance (ITI) is sensitive and accurate in detecting acute pulmonary edema even at its preclinical stage. We evaluated the suitability of the highly sensitive and noninvasive RS-207 monitor for detecting pleural effusion and for demonstrating increased ITI during i...

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Bibliographic Details
Published in:PloS one Vol. 10; no. 4; p. e0122576
Main Authors: Charach, Gideon, Rubalsky, Olga, Charach, Lior, Rabinovich, Alexander, Argov, Ori, Rogowski, Ori, George, Jacob
Format: Journal Article
Language:English
Published: United States Public Library of Science 28-04-2015
Public Library of Science (PLoS)
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Cardiography, Impedance - instrumentation
Cardiography, Impedance - methods
Case-Control Studies
Complications
Edema
Electric Impedance
Etiology
Female
Heart failure
Humans
Impedance
Internal medicine
Lungs
Male
Mechanical ventilation
Medicine
Methods
Middle Aged
Monitoring
Patients
Pleural effusion
Pleural Effusion - diagnosis
Pleural Effusion - physiopathology
Prospective Studies
Respiration
Respiratory rate
Sensitivity and Specificity
Skin
Thorax
Ventilation
Jerusalem Israel
Tel Aviv Israel
Israel
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Summary:Measurement of internal thoracic impedance (ITI) is sensitive and accurate in detecting acute pulmonary edema even at its preclinical stage. We evaluated the suitability of the highly sensitive and noninvasive RS-207 monitor for detecting pleural effusion and for demonstrating increased ITI during its resolution. This prospective controlled study was performed in a single department of internal medicine of a university-affiliated hospital between 2012-2013. One-hundred patients aged 25–96 years were included, of whom 50 had bilateral or right pleural effusion of any etiology (study group) and 50 had no pleural effusion (controls). ITI, the main component of which is lung impedance, was continuously measured by the RS-207 monitor. The predictive value of ITI monitoring was determined by 8 measurements taken every 8 hours. Pleural effusion was diagnosed according to well-accepted clinical and roentgenological criteria. During treatment, the ITI of the study group increased from 32.9±4.2 ohm to 42.8±3.8 ohm (p<0.0001) compared to non-significant changes in the control group (59.6±6.6 ohm, p = 0.24). Prominent changes were observed in the respiratory rate of the study group: there was a decrease from 31.2±4.0 to 19.5±2.4 ohm (35.2%) compared to no change for the controls, and a mean increase from 83.6± 5.3%-92.5±1.6% (13.2%) in O2 saturation compared to 94.2±1.7% for the controls. Determination of ITI for the detection and monitoring of treatment of patients with pleural effusion enables earlier diagnosis and more effective therapy, and can prevent hospitalization and serious complications, such as respiratory distress, and the need for mechanical ventilation. The study is registered at ClinicalTrials.gov NCT01601444.
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Conceived and designed the experiments: GC. Performed the experiments: OR OA AR. Analyzed the data: GC JG LC OR. Wrote the paper: GC OR JG.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0122576