Transthoracic electrical impedance: artifacts associated with electrode movement

The applicability of transthoracic impedance measurements for estimating thoracic fluid volume and tidal volume is limited by large variations associated with electrode movement, repeated application of electrodes and inter-individual differences. These sources of variation were studied with a four-electrode impedance-measuring device in anaesthetized dogs. Electrode movement artifacts affecting both the resting expiratory value of impedance (Zo) and the respiratory change of impedance (deltaZ/VT) could be largely eliminated by rigidly fixing the distances between the current-supplying and the potential-sensing electrodes. The reproducibility of Zo and deltaZ/VT was found to be affected adversely by local conductivity changes in the skin induced by repeated removal of the glued electrodes. Inter-individual variations in Zo and deltaZ/VT correlated with the thickness of thoracic subcutaneous fat (r = 0.86) and thoracic circumference (r = -0.95) respectively. Correction for these sources of inter-individual variation allowed the standard deviations of Zo and deltaZ/VT to be reduced from 18% to 7% and from 51% to 17% of their respective mean values.