Clinical implementation of electric impedance tomography in the treatment of ARDS: a single centre experience.
Clinical implementation of electric impedance tomography in the treatment of ARDS: a single centre experience.
复制标题
DOI：
10.1007/s10877-018-0164-x
复制
发表时间：
2019-04
影响因子：
2.2
通讯作者：
Bergmans DCJJ
中科院分区：
文献类型：
--
作者：
Heines SJH;Strauch U;van de Poll MCG;Roekaerts PMHJ;Bergmans DCJJ
报告我们在ARDS患者中使用EIT进行个体化PEEP滴定的临床经验。使用EIT评估，我们优化了39例ARDS患者的PEEP设置。将EIT PEEP设置与医生PEEP设置和根据ARDS网络的PEEP设置进行比较。我们将PEEP差值等于或大于4 cm H2O定义为临床相关。比较了基于EIT的PEEP调整患者和PEEP不变患者的肺顺应性和PaO 2/FiO 2比值的变化。在28%的患者中，基于EIT的PEEP和医生PEEP的差异具有临床相关性;在36%的患者中，基于EIT的PEEP和医生PEEP相等。基于EIT的PEEP与根据ARDS网络的PEEP设置不一致。根据EIT调整PEEP导致肺顺应性和PaO 2/FiO 2比值迅速增加。然而，在PEEP差异小于4 cm H2O的组中也观察到这种增加。我们推测这可能是由于PEEP试验期间肺泡复张所致。基于EIT的个体PEEP设置似乎是一种有前途的优化ARDS患者PEEP的方法。然而，其临床影响仍有待确定。本文的在线版本（10.1007/s10877-018-0164-x）包含补充材料，可供授权用户使用。
To report on our clinical experience using EIT in individualized PEEP titration in ARDS. Using EIT assessment, we optimized PEEP settings in 39 ARDS patients. The EIT PEEP settings were compared with the physicians’ PEEP settings and the PEEP settings according to the ARDS network. We defined a PEEP difference equal to or greater than 4 cm H2O as clinically relevant. Changes in lung compliance and PaO2/FiO2-ratio were compared in patients with EIT-based PEEP adjustments and in patients with unaltered PEEP. In 28% of the patients, the difference in EIT-based PEEP and physician-PEEP was clinically relevant; in 36%, EIT-based PEEP and physician-PEEP were equal. The EIT-based PEEP disagreed with the PEEP settings according to the ARDS network. Adjusting PEEP based upon EIT led to a rapid increase in lung compliance and PaO2/FiO2-ratio. However, this increase was also observed in the group where the PEEP difference was less than 4 cm H2O. We hypothesize that this can be attributed to the alveolar recruitment during the PEEP trial. EIT based individual PEEP setting appears to be a promising method to optimize PEEP in ARDS patients. The clinical impact, however, remains to be established. The online version of this article (10.1007/s10877-018-0164-x) contains supplementary material, which is available to authorized users.
登录
查看更多内容
DOI：
10.1186/s13054-015-1161-9
发表时间：
2016-01-08
期刊：
Critical care (London, England)
影响因子：
--
作者：
Karsten J;Stueber T;Voigt N;Teschner E;Heinze H
通讯作者：
Heinze H
DOI：
10.1186/cc9036
发表时间：
2010
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bikker IG;Leonhardt S;Reis Miranda D;Bakker J;Gommers D
通讯作者：
Gommers D
DOI：
10.1164/rccm.200710-1589oc
发表时间：
2008-08-15
影响因子：
24.7
作者：
Chiumello, Davide;Carlesso, Eleonora;Gattinoni, Luciano
通讯作者：
Gattinoni, Luciano
DOI：
10.1186/cc10354
发表时间：
2011-08-11
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bikker IG;Preis C;Egal M;Bakker J;Gommers D
通讯作者：
Gommers D
影响因子：
38.9
作者：
Costa, Eduardo L. V.;Borges, Joao Batista;Amato, Marcelo B. P.
通讯作者：
Amato, Marcelo B. P.