FOCUSED IMPEDANCE METHOD TO DETECT LOCALIZED LUNG VENTILATION DISORDERS IN COMBINATION WITH CONVENTIONAL SPIROMETRY
Conventional spirometry gives information on the overall ventilation of a person's lung; it cannot detect localized disorders in ventilation as occurring in pulmonary edema, pneumonia, tumor, TB, etc. Here we propose a new technique involving the recently developed focused impedance method (FIM) in combination with conventional spirometry to detect localized lung ventilation disorders. Electrical impedance of lung tissue changes as a function of air content and FIM provides a measurement of localized electrical impedance with sensitivity down to reasonable depths inside the body using a few surface electrodes; here we used a six-electrode version. At least four quadrants of the lungs in the frontal plane can be separately measured using a hand-held probe with spring backed skin surface electrodes. Firstly, spatial sensitivity distribution of the six-electrode FIM was obtained using finite element simulation which verified the focusing effect and its depth sensitivity. Percent change in impedance between maximum inspiration and expiration were measured at four quadrants of the chest of a healthy male subject giving four different values; that at the lower right quadrant was found to be the maximum, as also expected based on anatomy. Changes in impedance at this quadrant of the same subject were found to vary proportionately with exhaled air volumes, measured using a bellows-type spirometer. Similar FIM measurements at lower right lung of seven healthy subjects were found to be almost proportional (R2 = 0.7) to the total exhaled air volumes (vital capacity). This was the basis of the new technique. For a healthy individual, the ratio of the local impedance change to vital capacity (VC) will fall within a certain range for each of the four lung quadrants. A lower value at any quadrant would indicate disorder within that quadrant, while a larger value would indicate disorder in a region outside the particular quadrant. The FIM electrode probe can then be moved to take measurements at the other quadrants to locate the region of disorder. This preliminary study indicates that FIM in combination with conventional spirometry could be used to detect localized ventilation defects.