Separation of ventilation and perfusion of electrical impedance tomography image streams using multi-dimensional ensemble empirical mode decomposition.

Objective. In the future, thoracic electrical impedance tomography (EIT) monitoring may include continuous and simultaneous tracking of both breathing and heart activity. However, an effective way to decompose an EIT image stream into physiological processes as ventilation-related and cardiac-related signals is missing. Approach. This study analyses the potential of Multi-dimensional Ensemble Empirical Mode Decomposition by application of the Complete Ensemble Empirical Mode Decomposition with Adaptive Noise and a novel frequency-based combination criterion for detrending, denoising and source separation of EIT image streams, collected from nine healthy male test subjects with similar age and constitution. Main results. In this paper, a novel approach to estimate the lung, the heart and the perfused regions of an EIT image is proposed, which is based on the Root Mean Square Error between the index of maximal respiratory and cardiac variation to their surroundings. The summation of the indexes of the respective regions reveals physiologically meaningful time signals, separated into the physiological bandwidths of ventilation and heart activity at rest. Moreover, the respective regions were compared with the relative thorax movement and photoplethysmogram (PPG) signal. In linear regression analysis and in the Bland-Altman plot, the beat-to-beat time course of both the ventilation-related signal and the cardiac-related signal showed a high similarity with the respective reference signal. Significance. Analysis of the data reveals a fair separation of ventilatory and cardiac activity realizing the aimed source separation, with optional detrending and denoising. For all performed analyses, a feasible correlation of 0.587 to 0.905 was found between the cardiac-related signal and the PPG signal.