scholarly journals Electrical impedance tomography during major open upper abdominal surgery: a pilot-study

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Maximilian S Schaefer ◽  
Viktoria Wania ◽  
Bea Bastin ◽  
Ursula Schmalz ◽  
Peter Kienbaum ◽  
...  
Keyword(s):  
Pilot Study ◽  
Abdominal Surgery ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Impedance Tomography ◽  
Upper Abdominal Surgery ◽  
Upper Abdominal

scholarly journals Electrical Impedance Tomography Predicts Weaning Success in Adult Patients With Delayed Upper Abdominal Surgery: A Single-Center Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiajia Li ◽  
Fan Zeng ◽  
Fuxun Yang ◽  
Xiaoxiu Luo ◽  
Rongan Liu ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Electrical Impedance Tomography ◽  
Predictive Value ◽  
Electrical Impedance ◽  
Characteristic Curve ◽  
Ventilator Weaning ◽  
Impedance Tomography ◽  
Upper Abdominal Surgery ◽  
Generalized Estimation Equation ◽  
Upper Abdominal

Objective: To evaluate the predictive value of electrical impedance tomography (EIT) in patients with delayed ventilator withdrawal after upper abdominal surgery.Methods: We retrospectively analyzed data of patients who were ventilated >24 h after upper abdominal surgery between January 2018 and August 2019. The patients were divided into successful (group S) and failed (group F) weaning groups. EIT recordings were obtained at 0, 5, 15, and 30 min of spontaneous breathing trials (SBTs) with SBT at 0 min set as baseline. We assessed the change in delta end-expiratory lung impedance and tidal volume ratio (ΔEELI/VT) from baseline, the change in compliance change percentage variation (|Δ(CW-CL)|) from baseline, the standard deviation of regional ventilation delay index (RVDSD), and global inhomogeneity (GI) using generalized estimation equation analyses. Receiver operating characteristic curve analyses were performed to evaluate the predictive value of parameters indicating weaning success.Results: Among the 32 included patients, ventilation weaning was successful in 23 patients but failed in nine. Generalized estimation equation analysis showed that compared with group F, the ΔEELI/VT was lower, and the GI, RVDSD, and (|Δ(CW-CL)|) were higher in group S. For predicting withdrawal failure, the areas under the curve of the ΔEELI/VT, (|Δ(CW-CL)|), and the RVDSD were 0.819, 0.918, and 0.918, and 0.816, 0.884, and 0.918 at 15 and 30 min during the SBTs, respectively.Conclusion: The electrical impedance tomography may predict the success rate of ventilator weaning in patients with delayed ventilator withdrawal after upper abdominal surgery.

scholarly journals Effect of Electrical Impedance Tomography-Guided Early Mobilization in Patients After Major Upper Abdominal Surgery: Protocol for a Prospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuan Song ◽  
Daqiang Yang ◽  
Maopeng Yang ◽  
Yahu Bai ◽  
Bingxin Qin ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Electrical Impedance ◽  
Early Mobilization ◽  
Institutional Review Board ◽  
Ventilation Distribution ◽  
Impedance Tomography ◽  
Upper Abdominal Surgery ◽  
Institutional Review ◽  
Before And After ◽  
Upper Abdominal

Background: Pulmonary complications are common in patients after upper abdominal surgery, resulting in poor clinical outcomes and increased costs of hospitalization. Enhanced Recovery After Surgery Guidelines strongly recommend early mobilization post-operatively; however, the quality of the evidence is poor, and indicators for quantifying the effectiveness of early mobilization are lacking. This study will evaluate the effectiveness of early mobilization in patients undergoing an upper abdominal surgery using electrical impedance tomography (EIT). Specifically, we will use EIT to assess and compare the lung ventilation distribution among various regions of interest (ROI) before and after mobilization in this patient population. Additionally, we will assess the temporal differences in the distribution of ventilation in various ROI during mobilization in an effort to develop personalized activity programs for this patient population.Methods: In this prospective, single-center cohort study, we aim to recruit 50 patients after upper abdominal surgery between July 1, 2021 and June 30, 2022. This study will use EIT to quantify the ventilation distribution among different ROI. On post-operative day 1, the nurses will assist the patient to sit on the chair beside the bed. Patient's heart rate, blood pressure, oxygen saturation, respiratory rate, and ROI 1-4 will be recorded before the mobilization as baseline. These data will be recorded again at 15, 30, 60, 90, and 120 min after mobilization, and the changes in vital signs and ROI 1-4 values at each time point before and after mobilization will be compared.Ethics and Dissemination: The study protocol has been approved by the Institutional Review Board of Liaocheng Cardiac Hospital (2020036). The trial is registered at chictr.org.cn with identifier ChiCTR2100042877, registered on January 31, 2021. The results of the study will be presented at relevant national and international conferences and submitted to international peer-reviewed journals. There are no plans to communicate results specifically to participants. Important protocol modifications, such as changes to eligibility criteria, outcomes, or analyses, will be communicated to all relevant parties (including investigators, Institutional Review Board, trial participants, trial registries, journals, and regulators) as needed via email or in-person communication.

scholarly journals Individual Positive End-expiratory Pressure Settings Optimize Intraoperative Mechanical Ventilation and Reduce Postoperative Atelectasis

2018 ◽  
Vol 129 (6) ◽  
pp. 1070-1081 ◽  
Author(s):  
Sérgio M. Pereira ◽  
Mauro R. Tucci ◽  
Caio C. A. Morais ◽  
Claudia M. Simões ◽  
Bruno F. F. Tonelotto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Surgery ◽  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Lung Protective Ventilation ◽  
Positive End Expiratory Pressure ◽  
Lung Collapse ◽  
Tissue Mass ◽  
Impedance Tomography ◽  
Postoperative Atelectasis

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Intraoperative lung-protective ventilation has been recommended to reduce postoperative pulmonary complications after abdominal surgery. Although the protective role of a more physiologic tidal volume has been established, the added protection afforded by positive end-expiratory pressure (PEEP) remains uncertain. The authors hypothesized that a low fixed PEEP might not fit all patients and that an individually titrated PEEP during anesthesia might improve lung function during and after surgery. Methods Forty patients were studied in the operating room (20 laparoscopic and 20 open-abdominal). They underwent elective abdominal surgery and were randomized to institutional PEEP (4 cm H2O) or electrical impedance tomography–guided PEEP (applied after recruitment maneuvers and targeted at minimizing lung collapse and hyperdistension, simultaneously). Patients were extubated without changing selected PEEP or fractional inspired oxygen tension while under anesthesia and submitted to chest computed tomography after extubation. Our primary goal was to individually identify the electrical impedance tomography–guided PEEP value producing the best compromise of lung collapse and hyperdistention. Results Electrical impedance tomography–guided PEEP varied markedly across individuals (median, 12 cm H2O; range, 6 to 16 cm H2O; 95% CI, 10–14). Compared with PEEP of 4 cm H2O, patients randomized to the electrical impedance tomography–guided strategy had less postoperative atelectasis (6.2 ± 4.1 vs. 10.8 ± 7.1% of lung tissue mass; P = 0.017) and lower intraoperative driving pressures (mean values during surgery of 8.0 ± 1.7 vs. 11.6 ± 3.8 cm H2O; P < 0.001). The electrical impedance tomography–guided PEEP arm had higher intraoperative oxygenation (435 ± 62 vs. 266 ± 76 mmHg for laparoscopic group; P < 0.001), while presenting equivalent hemodynamics (mean arterial pressure during surgery of 80 ± 14 vs. 78 ± 15 mmHg; P = 0.821). Conclusions PEEP requirements vary widely among patients receiving protective tidal volumes during anesthesia for abdominal surgery. Individualized PEEP settings could reduce postoperative atelectasis (measured by computed tomography) while improving intraoperative oxygenation and driving pressures, causing minimum side effects.

Sign in / Sign up

Export Citation Format

Share Document