Bedside Evaluation of Pulmonary Embolism by Saline Contrast Electrical Impedance Tomography Method: A Prospective Observational Study

He, Huaiwu; Chi, Yi; Long, Yun; Yuan, Siyi; Zhang, Rui; Frerichs, Inéz; Möller, Knut; Fu, Feng; Zhao, Zhanqi

doi:10.1164/rccm.202005-1780le

Cited by 40 publications

(50 citation statements)

References 10 publications

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“…More and more evidence had shown contrast based-EIT method has the potential to quantitatively assess regional lung perfusion at various pathophysiologic conditions (such as PE, lung collapse, ARDS, response to PEEP change etc.) (1)(2)(3)(4)(5)(6). Further study is required to validate the impact of the described saline-based EIT method on decision making, therapeutic management and outcomes in critically ill patients.…”

Section: To the Editormentioning

confidence: 99%

Reply to Wang and Zhong: Bedside Evaluation of Pulmonary Embolism by Saline Contrast–enhanced Electrical Impedance Tomography: Considerations for Future Research

Long

Chi

et al. 2021

Am J Respir Crit Care Med

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Section: To the Editormentioning

confidence: 99%

Reply to Wang and Zhong: Bedside Evaluation of Pulmonary Embolism by Saline Contrast–enhanced Electrical Impedance Tomography: Considerations for Future Research

Long

Chi

et al. 2021

Am J Respir Crit Care Med

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“…We read with great interest the article by Huaiwu He et al (1) entitled "bedside evaluation of pulmonary embolism (PE) by saline contrast electrical impedance tomography method: A prospective observational study". The authors found PE-envoked regional perfusion defection could be detected with saline-contrasted EIT and claimed that the method showed high sensitivity and specificity for diagnosis of PE.…”

Section: To the Editormentioning

confidence: 99%

Bedside Evaluation of Pulmonary Embolism by Saline Contrast–enhanced Electrical Impedance Tomography: Considerations for Future Research

Wang

Ming

2021

Am J Respir Crit Care Med

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“…Electrical impedance tomography (EIT) is a noninvasive, non-radiation, and real-time monitoring method to monitor regional ventilation distribution at the bedside [5]. In recent advance, EIT was proposed to assess regional lung perfusion with saline bolus injection in ICU patients [6][7][8][9]. Hence, EIT would be the ideal bedside tool to evaluate the influence of PEEP on V-Q matching.…”

Section: Introductionmentioning

confidence: 99%

Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus

Chi

Long

et al. 2020

Crit Care

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Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 cmH2O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). DeadSpace%, Shunt%, and VQMatch% were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. ΔVQMatch% (VQMatch% at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and ΔSpO2 (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher Shunt% and lower VQMatch% than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable DeadSpace% was found in both groups. A high PEEP caused a significant improvement of VQMatch%, DeadSpace%, Shunt%, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of VQMatch% > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered.

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Bedside Evaluation of Pulmonary Embolism by Saline Contrast Electrical Impedance Tomography Method: A Prospective Observational Study

Cited by 40 publications

References 10 publications

Reply to Wang and Zhong: Bedside Evaluation of Pulmonary Embolism by Saline Contrast–enhanced Electrical Impedance Tomography: Considerations for Future Research

Reply to Wang and Zhong: Bedside Evaluation of Pulmonary Embolism by Saline Contrast–enhanced Electrical Impedance Tomography: Considerations for Future Research

Bedside Evaluation of Pulmonary Embolism by Saline Contrast–enhanced Electrical Impedance Tomography: Considerations for Future Research

Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus

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