Internal thoracic impedance monitoring: a novel method for the preclinical detection of acute heart failure

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Michael ShochatSimcha Meisel

Abstract

Acute heart failure (AHF) evolves through two phases. In the first phase, there is interstitial congestion with no clinical sign of edema (preclinical phase); the second, during which lung alveoli begin to fill with fluid, manifests as clinically overt alveolar edema. Treatment of AHF at its preclinical phase can alleviate its clinical impact. Presently, there is no technique that detects the interstitial phase of AHF. We used a device based on a new method of lung bioimpedance measurement. The device measures internal thoracic impedance (ITI), which nearly equals inherent lung bioimpedance. This method can detect small changes in lung fluid that occur during the interstitial stage of AHF. The objective of this study was to assess the feasibility and efficacy of the said new method in detecting preclinical AHF. Internal thoracic impedance and pertinent clinical parameters were monitored for 72 h in 403 patients hospitalized for an acute coronary syndrome without evidence of AHF at study entry. Seventy patients developed AHF during monitoring. Internal thoracic impedance decreased in these patients by 16.4% (95% CI=-12.2% to -20.6%; P<.0001) from the baseline level at 44+/-15.1 min prior to the onset of lung rales. The other 333...Continue Reading

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Citations

Jan 24, 2013·Journal of Geriatric Cardiology : JGC·Gideon CharachPavel Rabinovich
Nov 27, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Sean P CollinsDaniel J Lenihan
Apr 18, 2008·AACN Advanced Critical Care·Lynn Folan, Marjorie Funk
Apr 12, 2007·The Journal of Trauma·Karsten Knobloch

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