Regional distribution of ventilation in horses in dorsal recumbency during spontaneous and mechanical ventilation assessed by electrical impedance tomography: a case series

2017 ◽  
Vol 44 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Martina Mosing ◽  
Charlotte Marly-Voquer ◽  
Paul MacFarlane ◽  
David Bardell ◽  
Stephan H. Böhm ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Regional Distribution ◽  
Case Series ◽  
Impedance Tomography

scholarly journals Determination of respiratory gas flow by electrical impedance tomography in an animal model of mechanical ventilation

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Marc Bodenstein ◽  
Stefan Boehme ◽  
Stephan Bierschock ◽  
Andreas Vogt ◽  
Matthias David ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Animal Model ◽  
Electrical Impedance Tomography ◽  
Gas Flow ◽  
Electrical Impedance ◽  
Impedance Tomography

scholarly journals Electrical Impedance Tomography and Prone Position During Ventilation in COVID-19 Pneumonia: Case Reports and a Brief Literature Review

2020 ◽  
Vol 24 (4) ◽  
pp. 287-292
Author(s):  
Serena Tomasino ◽  
Rosa Sassanelli ◽  
Corrado Marescalco ◽  
Francesco Meroi ◽  
Luigi Vetrugno ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Literature Review ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Case Reports ◽  
Prone Positioning ◽  
Impedance Tomography ◽  
Pneumonia Case ◽  
Different Types ◽  
Novel Coronavirus

At the end of 2019, a novel coronavirus (COVID-19) was identified as the cause of a cluster of pneumonia cases, with high needs of mechanical ventilation in critically ill patients. It is still unclear whether different types of COVID-19 pneumonia require different ventilator strategies. With electrical impedance tomography (EIT) we evaluated, in real time and bedside, the distribution of ventilation in the different pulmonary regions before, during, and after pronation in COVID-19 respiratory failure. We present a brief literature review of EIT in non-COVID-19 patients and a report of 2 COVID-19 patients: one that did not respond well and another one that improved during and after pronation. EIT might be a useful tool to decide whether prone positioning should or should not be used in COVID-19 pneumonia.

scholarly journals Single-Lung Transplant Results in Position Dependent Changes in Regional Ventilation: An Observational Case Series Using Electrical Impedance Tomography

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kollengode Ramanathan ◽  
Hend Mohammed ◽  
Peter Hopkins ◽  
Amanda Corley ◽  
Lawrence Caruana ◽  
...  
Keyword(s):  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Mixed Model ◽  
Case Series ◽  
Regional Ventilation ◽  
Tidal Variation ◽  
Impedance Tomography ◽  
Lung Transplants ◽  
The Right ◽  
Diseased Lung

Background. Lung transplantation is the optimal treatment for end stage lung disease. Donor shortage necessitates single-lung transplants (SLT), yet minimal data exists regarding regional ventilation in diseased versus transplanted lung measured by Electrical Impedance Tomography (EIT).Method. We aimed to determine regional ventilation in six SLT outpatients using EIT. We assessed end expiratory volume and tidal volumes. End expiratory lung impedance (EELI) and Global Tidal Variation of Impedance were assessed in supine, right lateral, left lateral, sitting, and standing positions in transplanted and diseased lungs. A mixed model with random intercept per subject was used for statistical analysis.Results. EELI was significantly altered between diseased and transplanted lungs whilst lying on right and left side. One patient demonstrated pendelluft between lungs and was therefore excluded for further comparison of tidal variation. Tidal variation was significantly higher in the transplanted lung for the remaining five patients in all positions, except when lying on the right side.Conclusion. Ventilation to transplanted lung is better than diseased lung, especially in lateral positions. Positioning in patients with active unilateral lung pathologies will be implicated. This is the first study demonstrating changes in regional ventilation, associated with changes of position between transplanted and diseased lung.

scholarly journals Positive End-Expiratory Pressure Setting in COVID-19-Related Acute Respiratory Distress Syndrome: Comparison Between Electrical Impedance Tomography, PEEP/FiO2 Tables, and Transpulmonary Pressure

2021 ◽  
Vol 8 ◽  
Author(s):  
Sébastien Gibot ◽  
Marie Conrad ◽  
Guilhem Courte ◽  
Aurélie Cravoisy
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Distress Syndrome ◽  
Invasive Technique ◽  
Positive End Expiratory Pressure ◽  
Impedance Tomography

Introduction: The best way to titrate the positive end-expiratory pressure (PEEP) in patients suffering from acute respiratory distress syndrome is still matter of debate. Electrical impedance tomography (EIT) is a non-invasive technique that could guide PEEP setting based on an optimized ventilation homogeneity.Methods: For this study, we enrolled the patients with 2019 coronavirus disease (COVID-19)-related acute respiratory distress syndrome (ARDS), who required mechanical ventilation and were admitted to the ICU in March 2021. Patients were monitored by an esophageal catheter and a 32-electrode EIT device. Within 48 h after the start of mechanical ventilation, different levels of PEEP were applied based upon PEEP/FiO2 tables, positive end-expiratory transpulmonary (PL)/ FiO2 table, and EIT. Respiratory mechanics variables were recorded.Results: Seventeen patients were enrolled. PEEP values derived from EIT (PEEPEIT) were different from those based upon other techniques and has poor in-between agreement. The PEEPEIT was associated with lower plateau pressure, mechanical power, transpulmonary pressures, and with a higher static compliance (Crs) and homogeneity of ventilation.Conclusion: Personalized PEEP setting derived from EIT may help to achieve a more homogenous distribution of ventilation. Whether this approach may translate in outcome improvement remains to be investigated.

scholarly journals Gravitational distribution of regional opening and closing pressures, hysteresis and atelectrauma in ARDS evaluated by electrical impedance tomography

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Gaetano Scaramuzzo ◽  
Elena Spinelli ◽  
Savino Spadaro ◽  
Alessandro Santini ◽  
Donatella Tortolani ◽  
...  
Keyword(s):  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Regional Distribution ◽  
Low Flow ◽  
Dependent Lung ◽  
Impedance Tomography ◽  
Lung Physiology ◽  
Volume Curve ◽  
Opening And Closing ◽  
Closing Pressure

Abstract Background The physiological behavior of lungs affected by the acute respiratory distress syndrome (ARDS) differs between inspiration and expiration and presents heterogeneous gravity-dependent distribution. This phenomenon, highlighted by the different distribution of opening/closing pressure and by the hysteresis of the pressure–volume curve, can be studied by CT scan, but the technique expose the patient to radiations, cannot track changes during time and is not feasible at the bedside. Electrical impedance tomography (EIT) could help in assessing at the bedside regional inspiratory and expiratory mechanical properties. We evaluated regional opening/closing pressures, hysteresis and atelectrauma during inspiratory and expiratory low-flow pressure–volume curves in ARDS using electrical impedance tomography. Methods Pixel-level inspiratory and expiratory PV curves (PVpixel) between 5 and 40 cmH2O were constructed integrating EIT images and airway opening pressure signal from 8 ARDS patients. The lower inflection point in the inspiratory and expiratory PVpixel were used to find opening (OPpixel) and closing (CPpixel) pressures. A novel atelectrauma index (AtI) was calculated as the percentage of pixels opening during the inspiratory and closing during the expiratory PV curves. The maximal hysteresis (HysMax) was calculated as the maximal difference between normalized expiratory and inspiratory PV curves. Analyses were conducted in the global, dependent and non-dependent lung regions. Results Gaussian distribution was confirmed for both global OPpixel (r2 = 0.90) and global CPpixel (r2 = 0.94). The two distributions were significantly different with higher values for OPpixel (p < 0.0001). Regional OPpixel and CPpixel distributions were Gaussian, and in the dependent lung regions, both were significantly higher than in the non-dependent ones (p < 0.001). Both AtI and the HysMax were significantly higher in the dependent regions compared to the non-dependent ones (p < 0.05 for both). Conclusions Gravity impacts the regional distribution of opening and closing pressure, hysteresis and atelectrauma, with higher values in the dorsal lung. Regional differences between inspiratory and expiratory lung physiology are detectable at the bedside using EIT and could allow in-depth characterization of ARDS phenotypes and guide personalized ventilation settings. Graphic abstract

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