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Published in: Intensive Care Medicine 2/2003

01-02-2003 | Original

Estimation of regional lung volume changes by electrical impedance pressures tomography during a pressure-volume maneuver

Authors: Huibert R. van Genderingen, Adrianus J. van Vught, Jos R. C. Jansen

Published in: Intensive Care Medicine | Issue 2/2003

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Abstract

Objective

To assess the degree of linearity between lung volume and impedance change by electrical impedance tomography (EIT) in pigs with acute lung injury and to investigate regional impedance changes during a pressure-volume maneuver.

Design and setting

Experimental animal study in a university research laboratory.

Patients and participants

Nine pigs with lung injury induced by lung lavage.

Interventions

The lungs were insufflated to four different lung volumes. Next the lungs were inflated in steps up to 40 cmH2O and then in steps deflated.

Measurements and results

EIT measurements were performed. Impedance was highly linear with lung volume ( r 2=0.97). From the pressure-volume maneuver regional pressure-impedance (P-I) curves were obtained in the upper half (ventral) and lower half (dorsal) of the thoracic cross-section. Excellent fit was found of the regional P-I curves with a predefined sigmoid equation ( r 2=0.998). The P-I curves after lavage were markedly different than before lavage. The P-I curves recorded after lavage displayed a strong heterogeneity on the inflation limb: Lower corner pressure (traditionally lower inflection point) was significantly higher in the dorsal (28.3±4.1 cmH2O) than in the ventral region (17.5±4.3 cmH2O). The deflation limb displayed a more homogeneous pattern. Upper corner pressure and true inflection point, where the curve slope is maximal, in the dorsal region were only slightly higher than in the ventral region (1–2 cmH2O).

Conclusions

EIT and automated curve fitting provide information on regional lung inflation and deflation which may be of clinical use for optimizing ventilator settings.
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Metadata
Title
Estimation of regional lung volume changes by electrical impedance pressures tomography during a pressure-volume maneuver
Authors
Huibert R. van Genderingen
Adrianus J. van Vught
Jos R. C. Jansen
Publication date
01-02-2003
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 2/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-002-1586-x

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