Seventy-five Years of Use of Impedance Plethysmography in Physiological Data Acquisition and Medical Diagnostics.

ABSTRACT

Impedance plethysmography (IPG) came into existence in 1940 as a result of Jan Nyboer’s pioneering work in the noninvasive assessment of central and peripheral blood flow. The technique got an impetus after introduction first-time derivative of the impedance for accurate determination of stroke volume (SV) and various cardiac intervals. Later, this signal was employed by Parulkar et al for estimation of blood flow index (BFI) and differential pulse arrival time (DPAT) in various segments of the extremity, which were adequate to detect the aortic and peripheral arterial blocks and estimate collateral circulation and distal arterial runoff. The technique was widely used for measurement of respiration and body water. All these applications have resulted into use of bioimpedance for body composition analysis and continuous monitoring of cardiac output as US Food and Drug Adminstration (FDA) approved technologies, which are being used worldwide. Physiological variability has added more value to this technique as single data acquisition gives variability in heart rate and SV (or peripheral blood flow). Morphology index thus derived is very useful in screening patients suspected with coronary artery disease (CAD). All these milestones are briefly described in this paper.