Abstract
Retroperitoneal bleeding is commonly associated with blunt trauma to the abdomen. Current medical tools cannot be used for continuous monitoring of the bleeding. In the study, electrical impedance tomography (EIT) was applied to monitoring the retroperitoneal bleeding of an animal model. Six healthy swine were used. The process of retroperitoneal bleeding was simulated by the continuous injection of anticoagulated blood. For each subject, total blood of 200 mL or more was injected within different time periods ranging from tens of minutes to two hours. The bleeding was detected and monitored continuously by EIT system with 16 electrodes at a rate of one image per second. EIT images were reconstructed by dynamic back-projection algorithm. Mean resistivity value (MRV) of the bleeding region in EIT images was calculated and plotted over time. We found that impedance changes caused by the bleeding could be revealed by EIT images and MRV curves. MRV curve varied approximately linearly with the quantity of blood injected using regression analysis (R 2 = 0.90 to 0.99, p < 0.05). In total, 20 mL of blood volume changes could be identified by EIT. The progression of the retroperitoneal bleeding can be monitored by EIT in the proposed animal model. It suggests EIT is potential as a useful tool for continuous monitoring of retroperitoneal bleeding after blunt trauma.
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Adler, A., R. Amyot, R. Guardo, J. H. Bates, and Y. Berthiaume. Monitoring changes in lung air and liquid volumes with electrical impedance tomography. J. Appl. Physiol. 83(5):1762–1767, 1997.
Barber, D. C. A review of image reconstruction techniques for electrical impedance tomography. Med. Phys. 16(2):162–169, 1989.
Bayford, R. H., K. G. Boone, Y. Hanquan, and D. S. Holder. Improvement of the positional accuracy of EIT images of the head using a Lagrange multiplier reconstruction algorithm with diametric excitation. Physiol. Meas. 17:A49–A57, 1996.
Bikker, I. G., S. Leonhardt, J. Bakker, and D. Gommers. Lung volume calculated from electrical impedance tomography in ICU patients at different PEEP levels. Intensive Care Med. Published online: Jun 10, 2009.
Boverman, G., T. Kao, R. Kulkarni, B. S. Kim, D. Isaacson, G. J. Saulnier, and J. C. Newell. Robust linearized image reconstruction for multifrequency EIT of the breast. IEEE Trans. Med. Imaging 27(10):1439–1448, 2008.
Catalano, O., B. Cusati, A. Nunziata, and A. Siani. Active abdominal bleeding: contrast-enhanced sonography. Abdom. Imaging 31(1):9–16, 2006.
Franklin, G. A., and S. R. Casós. Current advances in the surgical approach to abdominal trauma. Injury 37(12):1143–1156, 2006.
Frerichs, I., T. Dudykevych, J. Hinz, M. Bodenstein, G. Hahn, and G. Hellige. Gravity effects on regional lung ventilation determined by functional EIT during parabolic flights. J. Appl. Physiol. 91(1):39–50, 2001.
Frerichs, I., G. Hahn, and G. Hellige. Thoracic electrical impedance tomographic measurements during volume controlled ventilation—effects of tidal volume and positive end-expiratory pressure. IEEE Trans. Med. Imaging 18(9):764–773, 1999.
Frerichs, I., G. Schmitz, S. Pulletz, D. Schädler, G. Zick, J. Scholz, and N. Weiler. Reproducibility of regional lung ventilation distribution determined by electrical impedance tomography during mechanical ventilation. Physiol. Meas. 28:S261–S267, 2007.
Goharian, M., M. Soleimani, A. Jegatheesan, K. Chin, and G. R. Moran. A DSP based multi-frequency 3D electrical impedance tomography system. Ann. Biomed. Eng. 36(9):1594–1603, 2008.
Heinrich, S., H. Schiffmann, A. Frerichs, A. Klockgether-Radke, and I. Frerichs. Body and head position effects on regional lung ventilation in infants: an electrical impedance tomography study. Intensive Care Med. 32(9):1392–1398, 2006.
Holder, D. S., and O. Gilad. Impedance changes recorded with scalp electrodes during visual evoked responses: implications for Electrical Impedance Tomography of fast neural activity. Neuroimage 47(2):514–522, 2009.
Kennedy, J. H., J. C. Denniston, L. E. Baker, C. H. Brown 3rd, C. W. Lewis, and T. C. Poder. Evaluation of a microcrystalline bovine collagen hemostatic agent in canine solid viscera injury using abdominal impedance plethysmography. Biomater. Med. Devices Artif. Organs 3(4):451–463, 1975.
Mangnall, Y. F., A. J. Baxter, R. Avill, N. C. Bird, B. H. Brown, D. C. Barber, A. D. Seagar, A. G. Johnson, and N. W. Read. Applied potential tomography: a new non-invasive technique for assessing gastric function. Clin. Phys. Physiol. Meas. 8(Suppl A):119–129, 1987.
Marco, G. G., S. Diego, A. Giulio, and S. Luca. Screening US and CT for blunt abdominal trauma: a retrospective study. Eur. J. Radiol. 56(1):97–101, 2005.
Pulletz, S., H. R. van Genderingen, G. Schmitz, G. Zick, D. Schädler, J. Scholz, N. Weiler, and I. Frerichs. Comparison of different methods to define regions of interest for evaluation of regional lung ventilation by EIT. Physiol. Meas. 27:S115–S127, 2006.
Sadleir, R. J., and A. Argibay. Modeling skull electrical properties. Ann. Biomed. Eng. 35(10):1699–1712, 2007.
Sadleir, R. J., and R. A. Fox. Detection and quantification of intraperitoneal fluid using electrical impedance tomography. IEEE Trans. Biomed. Eng. 48(4):484–491, 2001.
Sadleir, R. J., and T. Tang. Electrode configurations for detection of intraventricular haemorrhage in the premature neonate. Physiol. Meas. 30(1):63–79, 2009.
Salimi, J., K. Bakhtavar, M. Solimani, P. Khashayar, A. P. Meysamie, and M. Zargar. Diagnostic accuracy of CT scan in abdominal blunt trauma. Chin. J. Traumatol. 12(2):67–70, 2009.
Shuai, W. J., F. S. You, W. Zhang, H. Y. Zhang, F. Fu, X. T. Shi, R. G. Liu, C. H. Xu, X. Z. Dong, and T. Y. Bao. Image monitoring for an intraperitoneal bleeding model of pigs using electrical impedance tomography. Physiol. Meas. 29:217–225, 2008.
Soleimani, M. Computational aspects of low frequency electrical and electromagnetic tomography: a review study. Int. J. Numer. Anal. Model. 5(3):407–440, 2008.
Soulsby, C. T., M. Khela, E. Yazaki, D. F. Evans, E. Hennessy, and J. Powell-Tuck. Measurements of gastric emptying during continuous nasogastric infusion of liquid feed: electrical impedance tomography versus gamma scintigraphy. Clin. Nutr. 25(4):671–680, 2006.
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This work was partially supported by the Project of National Key Technology R&D Program of China under grant No. 2006BAI03A14 and by the Key Project of Natural Science Foundation of China under grant No. 50337020.
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Wanjun Shuai and Fusheng You contributed equally to this work.
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Shuai, W., You, F., Zhang, H. et al. Application of Electrical Impedance Tomography for Continuous Monitoring of Retroperitoneal Bleeding After Blunt Trauma. Ann Biomed Eng 37, 2373–2379 (2009). https://doi.org/10.1007/s10439-009-9778-y
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DOI: https://doi.org/10.1007/s10439-009-9778-y