Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography
Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography
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DOI：
10.1007/s00134-009-1447-y
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发表时间：
2009-06-01
影响因子：
38.9
通讯作者：
Amato, Marcelo B. P.
中科院分区：
文献类型：
--
作者：
Costa, Eduardo L. V.;Borges, Joao Batista;Amato, Marcelo B. P.
提出一种新的算法，用于在递减呼气末正压（PEEP）滴定过程中基于电阻抗断层扫描（EIT）估计可复张肺泡萎陷和过度扩张。技术说明和说明性病例报告。呼吸重症监护室。急性呼吸窘迫综合征患者。肺复张和PEEP滴定动作。同时采集EIT和X射线计算机断层扫描（CT）数据。我们发现EIT和CT估计的所有PEEP水平的塌陷之间的良好协议（在数量和空间位置）。患者1和2（保持肺萎陷< 10%）EIT检测到的最佳PEEP值分别为19和17 cmH2 O。虽然指向相同的非依赖性肺区域，EIT估计的过度扩张代表肺单位的功能恶化，而不是他们的解剖结构的变化，并不能直接与静态CT估计hyperinflation.We描述了一个EIT为基础的方法估计可招募肺泡萎陷在床边，指出其区域分布。此外，我们提出了一种基于局部肺力学的肺过度扩张的测量方法。
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.Technical note with illustrative case reports.Respiratory intensive care unit.Patients with acute respiratory distress syndrome.Lung recruitment and PEEP titration maneuver.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.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.