The electrode system in impedance-based ventilation measurement.

In this paper, we determined which electrode types, sizes, and locations were best suited for impedance-based ventilation measurement. Optimal electrodes provide high signal-to-(motion) artifact ratio (SAR) and reliability by meeting the following criteria: 1) low baseline impedance, 2) high adhesion, 3) good physical stability, 4) large effective area, 5) thin with high flexibility. We compared 14 electrodes from two main groups: adhesive-gel and conductive rubber electrodes. Adhesive-gel electrodes are easy to apply, make good body contact, and do not slip during the course of an experiment. We found that higher SAR's are obtained when electrode area is increased by connecting several small electrodes together rather than by using a single electrode with a larger area. The peak SAR is achieved when two electrode arrays (area = 70 cm2) are centered at the 8th intercostal spaces on opposite midaxillary lines. To determine the optimal electrode locations, we placed 32 electrodes on the trunk and recorded impedance between 171 electrode combinations on ten normal adult subjects. Based on these data, we conclude that the SAR's are highest when one electrode is placed on the midpoint between the left and right second intercostal spaces on the sternum and the other electrode is placed in the opposite position on the back.