Electrical impedance tomography in the clinical assessment of lung volumes following recruitment manoeuvres

Caruana, Lawrence R.; Paratz, Jennifer; Chang, Angela; Fraser, John F.

doi:10.1179/1743288x10y.0000000021

Cited by 9 publications

(17 citation statements)

References 72 publications

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“…10,11 The recorded changes can be used to create images of ventilation within the lungs both globally and regionally. 10,12,13 Due to the strong linear relationship between impedance change and volume change, 14,15 changes in lung volume can be accurately measured. In particular, this measurement technique has been shown to reliably and accurately detect changes in lung volume during and after endotracheal suctioning.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] A relatively new tool, electrical impedance tomography measures change in resistance or biological impedance to current flow. 9,10 Sixteen electrodes placed circumferentially around the thorax record the changes in impedance caused by the changes in air volume within the thorax during inspiration and expiration. 10,11 The recorded changes can be used to create images of ventilation within the lungs both globally and regionally.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Sixteen electrodes placed circumferentially around the thorax record the changes in impedance caused by the changes in air volume within the thorax during inspiration and expiration. 10,11 The recorded changes can be used to create images of ventilation within the lungs both globally and regionally. 10,12,13 Due to the strong linear relationship between impedance change and volume change, 14,15 changes in lung volume can be accurately measured.…”

Section: Introductionmentioning

confidence: 99%

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Lung Volume Changes During Cleaning of Closed Endotracheal Suction Catheters: A Randomized Crossover Study Using Electrical Impedance Tomography

et al. 2013

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BACKGROUND: Airway suctioning in mechanically ventilated patients is required to maintain airway patency. Closed suction catheters (CSCs) minimize lung volume loss during suctioning but require cleaning post-suction. Despite their widespread use, there is no published evidence examining lung volumes during CSC cleaning. The study objectives were to quantify lung volume changes during CSC cleaning and to determine whether these changes were preventable using a CSC with a valve in situ between the airway and catheter cleaning chamber. METHODS: This prospective randomized crossover study was conducted in a metropolitan tertiary ICU. Ten patients mechanically ventilated via volume-controlled synchronized intermittent mandatory ventilation (SIMV-VC) and requiring manual hyperinflation (MHI) were included in this study. CSC cleaning was performed using 2 different brands of CSC (one with a valve [Ballard Trach Care 72, Kimberly-Clark, Roswell, Georgia] and one without [Portex Steri-Cath DL, Smiths Medical, Dublin, Ohio]). The maneuvers were performed during both SIMV-VC and MHI. Lung volume change was measured via impedance change using electrical impedance tomography. A mixed model was used to compare the estimated means. RESULTS: During cleaning of the valveless CSC, significant decreases in lung impedance occurred during MHI (؊2563 impedance units, 95% CI 2213-2913, P < .001), and significant increases in lung impedance occurred during SIMV (762 impedance units, 95% CI 452-1072, P < .001). In contrast, cleaning of the CSC with a valve in situ resulted in non-significant lung volume changes and maintenance of normal ventilation during MHI and SIMV-VC, respectively (188 impedance units, 95% CI ؊136 to 511, P ‫؍‬ .22; and 22 impedance units, 95% CI ؊342 to 299, P ‫؍‬ .89). CONCLUSIONS: When there is no valve between the airway and suction catheter, cleaning of the CSC results in significant derangements in lung volume. Therefore, the presence of such a valve should be considered essential in preserving lung volumes and uninterrupted ventilation in mechanically ventilated patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lung Volume Changes During Cleaning of Closed Endotracheal Suction Catheters: A Randomized Crossover Study Using Electrical Impedance Tomography

et al. 2013

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“…EIT can measure changes in EELI only as long as the electrode belt is kept around the patient's chest. Upon removal and replacement of the belt, a new baseline is calculated, therefore EELI results are not comparable to those previously measured [48,[53][54][55], meaning that prolonged monitoring is difficult in a clinical setting.…”

Section: Electrical Impedance Tomographymentioning

confidence: 82%

“…A linear correlation exists between changes in the EELI and changes in EELV [48,50,109], although this relationship tends to over-estimate changes in EELV [109]. A limitation of time differencing EIT is that it is unable to detect the preexisting EELI [53,54] This study aimed to assess the effect of SVs on EELI. Based on the findings of prior case studies it was hypothesised that there is an increase in global EELI with the SV in-situ when patients are performing trials off the ventilator (i.e.…”

Section: Introductionmentioning

confidence: 99%

Towards an improved understanding of the effect of a speaking valve on lung volumes and communication in the critically ill tracheostomised patient

Sutt¹

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Tracheostomised mechanically ventilated patients are often left unable to speak, which is frustrating for patients and the staff caring for them. Having no voice causes major distress and feelings of helplessness for patients. Voicelessness frequently leads to reduced information exchange between the patient and healthcare team, frequently to the detriment of patient care. An in-line speaking valve (SV) is a one-way valve that may be used in the mechanical ventilation circuit to enable verbal communication in tracheostomised patients.Limited data exist regarding the effect of SVs on respiratory mechanics. Deflation of the tracheostomy cuff is required for placement of the SV, effectively causing a "leak" in the As an experienced speech pathologist, I believe concerns over SV use to date have little evidence. The main objective, and first aim of this thesis was to investigate the effect of SV use on respiratory mechanics to determine whether SVs should be used in-line with mechanical ventilation of tracheostomised patients. The second aim was to assess the effect of introducing SVs into a cardio-thoracic ICU on patient tracheostomy specific outcomes. The third aim was to further clarify the effect of SVs on success with healthrelated communication for ICU patients. To achieve these aims, 5 studies were conducted, resulting in 5 manuscripts.For the first aim, 20 tracheostomised ICU patients using a SV that met the inclusion criteria were recruited to the study from November 2013-December 2014. Electrical Impedance iii Tomography (EIT) was used to assess the patients' end-expiratory lung impedance (EELI) and ventilation distribution continuously over 60 minutes (before, during and after SV use). For the third aim, 25 patients and 52 nursing staff were asked to fill out a custom-made questionnaire on success with health communication, firstly when the patients were voiceless, and, secondly, when they were using a SV. Chapter 7 highlights individual differences and some disparity between patient and nursing ratings of communication success. Overall, however, following SV use both the patients and nursing staff reported a significant improvement in success with health communication. Additional variables included oxygenation (SpOIn conclusion, the findings of this thesis addressed the research aims, and provide new knowledge through use of an innovative approach to assessing lung mechanics. Having iv already resulted in real clinical changes in our centre, the results indicate the potential for optimising communication, using SVs in tracheostomised cardiothoracic ICU patients undergoing weaning from mechanical ventilation.v

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Normal saline and lung recruitment with paediatric endotracheal suction (NARES): A pilot, factorial, randomised controlled trial

Schults

Cooke

Long

et al. 2021

Australian Critical Care

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Electrical impedance tomography in the clinical assessment of lung volumes following recruitment manoeuvres

Cited by 9 publications

References 72 publications

Lung Volume Changes During Cleaning of Closed Endotracheal Suction Catheters: A Randomized Crossover Study Using Electrical Impedance Tomography

Lung Volume Changes During Cleaning of Closed Endotracheal Suction Catheters: A Randomized Crossover Study Using Electrical Impedance Tomography

Towards an improved understanding of the effect of a speaking valve on lung volumes and communication in the critically ill tracheostomised patient

Normal saline and lung recruitment with paediatric endotracheal suction (NARES): A pilot, factorial, randomised controlled trial

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