On-Line Electrical Impedance Measurement for Monitoring Blood Viscosity during On-Pump Heart Surgery

Abstract

Background: The viscosity of blood (η) as well as its electrical impedance at 20 kHz at high shear rate depends on hematocrit, temperature, concentration of macromolecules and red cell deformability. The aim of our study was to investigate the relation between viscosity and electrical impedance in a heart-lung machine-like set-up, because during on-pump heart surgery considerable viscosity changes occur. Methods: Blood of 10 healthy volunteers was examined under temperature variation between 18.5 and 37°C at four different levels of hemodilution. Blood viscosity was examined with a golden-standard technique, i.e. a Contraves LS 30 Couette viscometer, and the results were compared with measurements of the electrical resistivity (R) at 20 kHz by a specially designed device in series with the tubing system of a heart-lung machine. All measurements were performed at a shear rate of 87 s^–1. Results: Using stepwise multiparameter regression analysis (SPSS) a highly significant correlation was found (r² = 0.882) between viscosity (η) and resistivity (R). Adding the variables sodium ([Na⁺]) and fibrinogen ([Fibr]) concentration the coefficient of correlation further improved to r² = 0.928 and the relation became: η = –0.6844 + 0.038 R + 0.038 [Na⁺] + 0.514 [Fibr]. All coefficients showed a statistical significance of p < 0. 001. Conclusions: Electrical impedance measurement is feasible in a heart-lung machine-like set-up and allows accurate continuous on-line estimation of blood viscosity; it may offer an adequate way to record and control viscosity changes during on-pump heart surgery.