Tracheobronchomalacia in a patient on invasive mechanical ventilation: the role of electrical impedance tomography in its detection and positive end-expiratory pressure titration

Dias, Olívia Meira; Costa, Eduardo Leite Vieira; Pereira, Daniel; Chaves, Caroline N.; Rached, Samia Zahi; Barbas, Carmen Sílvia Valente

doi:10.1590/s1806-37132015000004410

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…It can also be used to precisely evaluate the ventilation status of a specific area of the tissue through the device's localized monitoring function, thus helping clinical staff determine whether a patient is in a pathological state or exhibiting a degree of recovery from a disease. [7][8][9][10][11][12][13] In preliminary observations of ventilator weaning under EIT monitoring, we have found that a proportion of patients who meet the criteria for ventilator weaning according to the traditional evaluation system show poor inspiratory and expiratory imaging of the lungs when EIT is applied, ie, significantly smaller impedance values and decreased blood oxygen and respiratory muscle fatigue during the continuation of the spontaneous breathing trial (SBT). However, in other patients who do not fully meet the predictors for ventilator weaning, the EIT imaging suggests good ventilation of the lungs and continues to be stable after extubation.…”

Section: Introductionmentioning

confidence: 99%

The Application of Electrical Impedance Tomography During the Ventilator Weaning Process

Wang¹,

Zhang²,

Li³

et al. 2021

IJGM

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Background: This study proposes the investigation of electrical impedance tomography (EIT) as a useful predictor for ventilator weaning. Methods: The study design was a nested case-control study and patients who were admitted to the intensive care unit and underwent their first tracheal intubation were enrolled. Those who successfully completed ventilator weaning and extubation after the first spontaneous breathing trial (SBT) were included in the weaning success group, while those who did not pass the SBT or received secondary intubation within 48 hours were included in the weaning failure group. In both groups, EIT was adopted to record the monitoring data in three phases: before the SBT (pre-SBT), during the SBT (SBT), and after the SBT (post-SBT). Results: A total of 53 patients were enrolled, including 41 cases in the weaning success group and 12 cases in the weaning failure group. The logistic regression analysis showed that the pre-SBT global impedance (GI) and the SBT region of interest 2 (ROI2) were significantly higher in the weaning success group than in the weaning failure group (p = 0.0001 and p = 0.002). The pre-SBT GI predicted weaning success with a sensitivity of 0.524, a specificity of 0.818, a p-value of 0.0496, and a 95% confidence interval (CI) of 0.001-0.978. The sensitivity, specificity, p-value, and 95% CI for the SBT ROI2 were 1, 0.595, 0.0164, and 1.010-1.108, respectively. Conclusion: For patients without contraindications to EIT, the application of EIT is recommended to be added to the existing evaluation system for ventilator weaning, as it could help improve the weaning success rate. Further cohort studies are needed to investigate the actual efficacy of EIT after it has been added to the evaluation system.

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Section: Introductionmentioning

confidence: 99%

The Application of Electrical Impedance Tomography During the Ventilator Weaning Process

Wang¹,

Zhang²,

Li³

et al. 2021

IJGM

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“…It is similar to conventional computed tomography, but the difference is that EIT is continuous and dynamic, re ecting changes in the pulmonary tissue during inspiration and expiration in real time through the monitoring screen, and can also be used to speci cally evaluate the ventilation status of a certain area of the tissue through the device's localized monitoring function, thus helping clinical staff determine whether a patient is in a pathological state or the degree of recovery of a disease. [7][8][9][10][11][12][13] In preliminary observations in patients conducting ventilator weaning under EIT monitoring, we have found that a proportion of patients meet the criteria for ventilator weaning but that the EIT monitoring shows poor inspiratory and expiratory imaging of the lungs, i.e., signi cantly smaller impedance values and decreased blood oxygen and respiratory muscle fatigue during the continuation of the spontaneous breathing trial (SBT). However, in other patients who do not fully meet the predictors for ventilator weaning, the EIT imaging suggests good ventilation of the lungs and continues to be stable after extubation.…”

Section: Introductionmentioning

confidence: 99%

The Application of Electric Impedance Tomography During the Ventilator Weaning Process

Wang

Zhang

et al. 2021

Preprint

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Background The existing evaluation system for ventilator weaning should consider adding new reference indicators to improve the weaning success rate. In the present study, we proposed investigating whether electrical impedance tomography (EIT) is a useful predictor for ventilator weaning. Methods The study design was a nested case–control study, and patients who were admitted to the intensive care unit and underwent their first tracheal intubation were enrolled. Those who successfully completed the ventilator weaning and extubation after the first spontaneous breathing trial (SBT) were included in the trial group, while those who did not pass the SBT or who received secondary intubation within 48 hours after extubation were included in the control group. Here, EIT was adopted to record the monitoring data in three phases, i.e., before the SBT (pre-SBT), during the SBT (SBT), and after the SBT (post-SBT), in both groups. The MATLAB 7.2 software was used to process the EIT data, the SAS 9.4 software was adopted for the statistical analysis, and logistic regression was used to analyze the factors associated with weaning success. Results A total of 53 patients were enrolled, including 41 cases in the trial group and 12 cases in the control group. The logistic regression analysis showed that the pre-SBT global impedance (GI) and the SBT region of interest 2 (ROI2) were significantly higher in the trial group than in the control group (p = 0.0001 and p = 0.002). The pre-SBT GI predicted weaning success with a sensitivity of 0.524, a specificity of 0.818, a p-value of 0.0496, and a 95% confidence interval (CI) of 0.001–0.978. The sensitivity, specificity, p-value, and 95% CI for the SBT ROI2 were 1, 0.595, 0.0164, and 1.010–1.108, respectively. Conclusion For patients without contraindications to EIT, the application of EIT is recommended to be added to the existing evaluation system for ventilator weaning as it could help improve the weaning success rate. Further cohort studies are needed to investigate the actual efficacy of EIT after it has been added to the evaluation system.

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Unexpected Airway Collapse: A Rare Case of Spontaneous Postoperative Tracheobronchomalacia in the Absence of Identifiable Risk Factors

Roberts,

Price,

Chernicki

et al. 2024

Cureus

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Tracheobronchomalacia in a patient on invasive mechanical ventilation: the role of electrical impedance tomography in its detection and positive end-expiratory pressure titration

Cited by 3 publications

References 9 publications

The Application of Electrical Impedance Tomography During the Ventilator Weaning Process

The Application of Electrical Impedance Tomography During the Ventilator Weaning Process

The Application of Electric Impedance Tomography During the Ventilator Weaning Process

Unexpected Airway Collapse: A Rare Case of Spontaneous Postoperative Tracheobronchomalacia in the Absence of Identifiable Risk Factors

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