Monitoring of cardiac output and lung ventilation by Electrical Impedance Tomography in a porcine model of acute lung injury

Adequate medical treatment of the Acute Respiratory Distress Syndrome is still challenging since patient-individual aspects have to be taken into account. Lung protective ventilation and hemodynamic stability have always been two of the most crucial aims of intensive care therapy. For both aspects, a continuous - preferably non-invasive - monitoring is desirable that is available at the bedside. Unfortunately, there is no technique clinically established yet, that provides both measurement of cardiac stroke volume and ventilation dynamics in real-time. Electrical Impedance Tomography (EIT) is a promising technique to close this gap. The aim of the study was to investigate if stroke volume can be estimated by a self-developed software using EIT-based image analysis. In addition, two EIT-derived parameters, namely Global Inhomogeneity Index (GII) and Impedance Ratio (IR), were calculated to evaluate homogeneity of air distribution.

[1]  H Kanai [Electrical impedance tomography]. , 1991, Nihon rinsho. Japanese journal of clinical medicine.

[2]  Burkhard Lachmann,et al.  Monitoring of recruitment and derecruitment by electrical impedance tomography in a model of acute lung injury , 2000, Critical care medicine.

[3]  Zhanqi Zhao,et al.  Evaluation of an electrical impedance tomography-based global inhomogeneity index for pulmonary ventilation distribution , 2009, Intensive Care Medicine.

[4]  Steffen Leonhardt,et al.  Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group , 2016, Thorax.

[5]  T L Petty,et al.  Acute respiratory distress in adults. , 1967, Lancet.

[6]  T. Faes,et al.  Electrical impedance tomography to measure pulmonary perfusion: is the reproducibility high enough for clinical practice? , 2003, Physiological measurement.

[7]  Arthur S Slutsky,et al.  Acute Respiratory Distress Syndrome The Berlin Definition , 2012 .

[8]  B M Eyüboglu,et al.  Methods of cardiac gating applied potential tomography. , 1988, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[9]  D C Barber,et al.  An assessment of dynamic images by applied potential tomography for monitoring pulmonary perfusion. , 1988, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[10]  S Leonhardt,et al.  Dynamic separation of pulmonary and cardiac changes in electrical impedance tomography , 2008, Physiological measurement.

[11]  O. Stenqvist,et al.  Monitoring pulmonary perfusion by electrical impedance tomography: an evaluation in a pig model , 2009, Acta anaesthesiologica Scandinavica.

[12]  Thomas E. Stewart,et al.  Pressure and Volume Limited Ventilation for the Ventilatory Management of Patients with Acute Lung Injury: A Systematic Review and Meta-Analysis , 2011, PloS one.

[13]  M. Cecconi,et al.  Haemodynamic monitoring in the peri‐operative period: the past, the present and the future , 2017, Anaesthesia.

[14]  Matthias Briel,et al.  Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. , 2010, JAMA.

[15]  G. Zimmerman,et al.  The acute respiratory distress syndrome. , 2012, The Journal of clinical investigation.

[16]  Steffen Leonhardt,et al.  Experimental case report: development of a pneumothorax monitored by electrical impedance tomography , 2009, Clinical physiology and functional imaging.

[17]  Steffen Leonhardt,et al.  Recent Advances in and Limitations of Cardiac Output Monitoring by Means of Electrical Impedance Tomography , 2014, Anesthesia and analgesia.

[18]  Inéz Frerichs,et al.  Assessment of Changes in Distribution of Lung Perfusion by Electrical Impedance Tomography , 2009, Respiration.

[19]  D. Schoenfeld,et al.  Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. , 2000, The New England journal of medicine.

[20]  Michael A. Matthay,et al.  Acute respiratory distress syndrome , 1996, Nature reviews. Disease primers.