Summary
Transthoracic impedance cardiography is a noninvasive method to determine changes in cardiac output on the basis of the cardiac-induced impedance change measured across the thorax. In this report, we describe a new, easily applied, tetrapolar spot-electrode configuration for use in canine transthoracic impedance cardiography. The array is a convenient alternative to use of the traditional circumferential band-electrode array which, in the dog, is prohibitive because of the extensive skin preparation required. The spot-electrode array was used to compare changes in cardiac output measured by transthoracic impedance cardiography, with changes measured by a reference indicator-dilution technique.
A spot-electrode array, composed of 4 standard ECG electrodes, was used to measure transthoracic impedance in 10 anesthetized dogs. Variations in cardiac output were produced by controlled hemorrhage (200- to 250-ml increments). Simultaneous reference measurements of cardiac output were made before hemorrhage (control) and at each level of hemorrhage, using the saline-dilution method. The beat-by-beat impedance changes were measured by use of a Minnesota impedance cardiograph, which also recorded the first derivative of impedance (dZ/dt). An index of cardiac output was defined as the product of the maximal value of the first time derivative of impedance, ejection time, and heart rate for each beat during inscription of a saline-dilution curve. The average of the beat-bybeat indices was calculated and then normalized relative to the initial control value. Linear regression analysis was performed to evaluate the correlation of the index of cardiac output with the reference cardiac output. The slope and correlation coefficient for the pooled data were 0.90 and 0.92, respectively. These results indicate that changes in cardiac output can be tracked reliably in anesthetized dogs by transthoracic impedance cardiography by use of a convenient spotelectrode configuration.
