Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography
Objective To present a novel algorithm for estimating recruitable alveolar collapse and hyperdistension based on electrical impedance tomography (EIT) during a decremental positive end-expiratory pressure (PEEP) titration. Design Technical note with illustrative case reports. Setting Respiratory intensive care unit. Patient Patients with acute respiratory distress syndrome. Interventions Lung recruitment and PEEP titration maneuver. Measurements and results Simultaneous acquisition of EIT and X-ray computerized tomography (CT) data. We found good agreement (in terms of amount and spatial location) between the collapse estimated by EIT and CT for all levels of PEEP. The optimal PEEP values detected by EIT for patients 1 and 2 (keeping lung collapse <10%) were 19 and 17 $ cmH_{2} $O, respectively. Although pointing to the same non-dependent lung regions, EIT estimates of hyperdistension represent the functional deterioration of lung units, instead of their anatomical changes, and could not be compared directly with static CT estimates for hyperinflation. Conclusions We described an EIT-based method for estimating recruitable alveolar collapse at the bedside, pointing out its regional distribution. Additionally, we proposed a measure of lung hyperdistension based on regional lung mechanics..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2009 |
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| Erschienen: |
2009 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Intensive care medicine - 35(2009), 6 vom: 03. März, Seite 1132-1137 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Costa, Eduardo L. V. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Acute lung injury |
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| Anmerkungen: |
© Springer-Verlag 2009 |
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| doi: |
10.1007/s00134-009-1447-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
SPR001205757 |
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| 100 | 1 | |a Costa, Eduardo L. V. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography |
| 264 | 1 | |c 2009 | |
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| 500 | |a © Springer-Verlag 2009 | ||
| 520 | |a Objective To present a novel algorithm for estimating recruitable alveolar collapse and hyperdistension based on electrical impedance tomography (EIT) during a decremental positive end-expiratory pressure (PEEP) titration. Design Technical note with illustrative case reports. Setting Respiratory intensive care unit. Patient Patients with acute respiratory distress syndrome. Interventions Lung recruitment and PEEP titration maneuver. Measurements and results Simultaneous acquisition of EIT and X-ray computerized tomography (CT) data. We found good agreement (in terms of amount and spatial location) between the collapse estimated by EIT and CT for all levels of PEEP. The optimal PEEP values detected by EIT for patients 1 and 2 (keeping lung collapse <10%) were 19 and 17 $ cmH_{2} $O, respectively. Although pointing to the same non-dependent lung regions, EIT estimates of hyperdistension represent the functional deterioration of lung units, instead of their anatomical changes, and could not be compared directly with static CT estimates for hyperinflation. Conclusions We described an EIT-based method for estimating recruitable alveolar collapse at the bedside, pointing out its regional distribution. Additionally, we proposed a measure of lung hyperdistension based on regional lung mechanics. | ||
| 650 | 4 | |a Electrical impedance tomography |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Computed tomography |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Acute lung injury |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Acute respiratory distress syndrome |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Lung recruitment |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Positive end-expiratory pressure |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Mechanical ventilation |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Borges, João Batista |4 aut | |
| 700 | 1 | |a Melo, Alexandre |4 aut | |
| 700 | 1 | |a Suarez-Sipmann, Fernando |4 aut | |
| 700 | 1 | |a Toufen, Carlos |4 aut | |
| 700 | 1 | |a Bohm, Stephan H. |4 aut | |
| 700 | 1 | |a Amato, Marcelo B. P. |4 aut | |
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