Document Type thesis Author Name Songer, Jocelyn Evelyn URN etd-0827101-212826 Title Tissue Ischemia Monitoring Using Impedance Spectroscopy: Clinical Evaluation Degree MS Department Biomedical Engineering Advisors Stevan Kun, Ph.D., Advisor Raymond Dunn, M.D., Committee Member Sergey Makarov, Committee Member Robert Peura, Co-Advisor Keywords impedance spectroscopy non-invasive instrumentation ischemia Date of Presentation/Defense 2001-06-22 Availability unrestricted Abstract
Ischemia is a condition of decreased tissue viability caused
by a lack of perfusion, which prevents the delivery of oxygen
and nutrients to biological tissue. Ischemia plays a major
role in many clinical disorders, yet there are limited means
by which tissue viability can be assessed. The long-term
objective of this research is to develop a non-invasive or
non-contact instrument for quantifying human tissue
ischemia. Skeletal muscle ischemia is evaluated at this stage
because skeletal muscle is easily accessible, its ischemia
represents a clinical problem, and it can endure short periods
of ischemia without suffering permanent injury. The ischemia
monitor designed for this study is based on impedance
spectroscopy, the measurement of tissue impedance at various
frequencies. This study had three major goals.
The first goal was to improve upon the design of the ischemia
monitor to achieve optimal system performance in a clinical
environment. Major considerations included electrode
sterility, instrument mobility, and electrosurgical unit
interference.
The second goal was to collect both impedance and pH data from
human subjects undergoing tourniquet surgeries, which induce
skeletal muscle ischemia and result in changes of the tissue's
pH and impedance. The average in recorded pH during ischemia
was 0.0053 pH units/minute and the average change in Ro was
-0.1481 Ohms/minute.
The third goal was to develop a relationship between
parameters of tissue impedance and pH utilizing neural
networks. This goal was accomplished in three stages. First,
the optimal neural network type for classifying impedance data
and pH values was determined. Based on these results, the
backpropagation neural network was utilized for all subsequent
work. Then, the input parameters of the neural network were
optimized using previously collected data. The number of
inputs to the previously developed neural network were reduced
by 35% (13/20) with a maximum of a 3% reduction in neural
network performance. Finally, the neural network was trained
and tested using human impedance and pH data. The network was
able to correctly estimate tissue pH values with an average
error of 0.0440 pH units.
Through the course of this research the ischemia monitor based
on impedance spectroscopy was improved, a methodology for the
use of the instrument in the operating room was developed, and
a preliminary relationship between parameters of impedance
spectra and pH was established. The results of this research
indicate the feasibility of the instrument to monitor both pH
and impedance in a clinical setting. Additionally, it was
demonstrated that impedance data collected non-invasively
could be used to estimate the pH and level of ischemia in
human skeletal muscle.
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