From bioimpedance to volume estimation: A model for edema calculus in human legs

Abstract

Heart failure (HF) is a severe disease and one of the most important causes of death in our society nowadays. A significant percentage of patients hospitalized for decompensation of heart failure are readmitted after some weeks or months due to an expected bad and uncontrolled HF evolution due to the lack of the patient supervision in real time. Herein is presented a straightforward electric model useful for volume leg section calculus based on the bioimpedance test as a way to assist with the acute HF patient’s supervision. The method has been developed for time-evolution edema evaluation in patients’ corresponding legs. The data are picked up with a wearable device specifically developed for acute heart failure patients. As an initial step, a calibration method is proposed to extract the extracellular volume component from bioimpedance measurements done in healthy subjects, and then applied to unhealthy ones. The intra- and extracellular resistance components are calculated from fitted Cole–Cole model parameters derived from BI spectroscopy measurements. Results obtained in a pilot assay, with healthy subjects and heart failure subjects, show sensitivities in leg volume [mL/Ω], with much lower values for healthy than in unhealthy people, being an excellent biomarker to discriminate between both. Finally, circadian cycle evolution for leg volume has been measured from the bioimpedance test as an extension of the work, enabling an alternative parameter for the characterization of one day of human activity for any person.