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01-06-2009 | Physiological and Technical Notes

Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography

Authors: Eduardo L. V. Costa, João Batista Borges, Alexandre Melo, Fernando Suarez-Sipmann, Carlos Toufen Jr, Stephan H. Bohm, Marcelo B. P. Amato

Published in: Intensive Care Medicine | Issue 6/2009

Abstract

Objective

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.

Design

Technical note with illustrative case reports.

Setting

Respiratory intensive care unit.

Patient

Patients with acute respiratory distress syndrome.

Interventions

Lung recruitment and PEEP titration maneuver.

Measurements and results

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 cmH₂O, 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.

Conclusions

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.

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Title: Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography
Authors: Eduardo L. V. Costa
João Batista Borges
Alexandre Melo
Fernando Suarez-Sipmann
Carlos Toufen Jr
Stephan H. Bohm
Marcelo B. P. Amato
Publication date: 01-06-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 6/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1447-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography

Abstract

Objective

Design

Setting

Patient

Interventions

Measurements and results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Design

Setting

Patient

Interventions

Measurements and results

Conclusions

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