Electrical Impedance Tomography to Detect Airway Closure Heterogeneity in Asymmetrical Acute Respiratory Distress Syndrome

Rozé, Hadrien; Boisselier, Clément; Bonnardel, Éline; Perrier, Virginie; Repusseau, Benjamin; Brochard, Laurent; Ouattara, Alexandre

doi:10.1164/rccm.202007-2937le

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…This can be measured with a double lumen tube or bronchial blocker and lung low flow pressure–volume (PV) curves. 20 46 The more injured lung will have a lower compliance and a lower aerated lung volume, as it has been described on both lungs' PV curve in ARDS. 50 A method using one lung ventilation cannot be used routinely but it has been successfully compared with the EIT-derived PV curve method recently to assess unilateral compliance in asymmetrical ARDS.…”

Section: Definition/diagnostic Of Asymmetrical Acute Respiratory Dist...mentioning

confidence: 85%

“…4 and 5 ). 46 The highest AOP was in the sickest lung with the lowest compliance. The value of AOP on the classical global PV curve using spirometry on the ventilator, however, was almost the same than the less-sick lung since both lungs are connected in parallel.…”

Section: Airway Closure During Asymmetrical Lung Injury: Detection An...mentioning

confidence: 94%

“…A PEEP titration method using PEEP EIT decremental protocol in asymmetrical lung injury will take into account the alveolar collapse of the lung with the highest AOP and therefore such method will propose a level of PEEP close to the highest AOP measured with EIT-derived PV curve. 46 At the same time, it will show overdistension in the lung with the lowest AOP and highest compliance, and propose a compromise of PEEP level between alveolar collapse and overdistension for a given tidal volume.…”

Section: Airway Closure During Asymmetrical Lung Injury: Detection An...mentioning

confidence: 99%

“…A difference of at least 20% of lung volume distribution in each lung can be a reasonable criterion for asymmetrical lung injury. 46 Another aspect of asymmetrical lung injury can also be the difference in end expiratory lung volume changes that can also be compared between the lungs with end expiratory lung impedance using EIT.…”

Section: Definition/diagnostic Of Asymmetrical Acute Respiratory Dist...mentioning

confidence: 99%

“…50 A method using one lung ventilation cannot be used routinely but it has been successfully compared with the EIT-derived PV curve method recently to assess unilateral compliance in asymmetrical ARDS. 46 Therefore the same single PV curve can be used in differentiating the different changes of volume in each lung, and therefore allowing to identify the respective elastic behavior of each lung.…”

Section: Definition/diagnostic Of Asymmetrical Acute Respiratory Dist...mentioning

confidence: 99%

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Asymmetrical Lung Injury: Management and Outcome

Bastia

Rozé

Brochard

2022

Semin Respir Crit Care Med

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Among mechanically ventilated patients, asymmetrical lung injury is probably extremely frequent in the intensive care unit but the lack of standardized measurements does not allow to describe any prevalence among mechanically ventilated patients. Many past studies have focused only on unilateral injury and have mostly described the effect of lateral positioning. The good lung put downward might receive more perfusion while the sick lung placed upward receive more ventilation than supine. This usually results in better oxygenation but can also promote atelectasis in the healthy lung and no consensus has emerged on the clinical indication of this posture. Recently, electrical impedance tomography (EIT) has allowed for the first time to precisely describe the distribution of ventilation in each lung and to better study asymmetrical lung injury. At low positive-end-expiratory pressure (PEEP), a very heterogeneous ventilation exists between the two lungs and the initial increase in PEEP first helps to recruit the sick lung and protect the healthier lung. However, further increasing PEEP distends the less injured lung and must be avoided. The right level can be found using EIT and transpulmonary pressure. In addition, EIT can show that in the two lungs, airway closure is present but with very different airway opening pressures (AOPs) which cannot be identified on a global assessment. This may suggest a very different PEEP level than on a global assessment. Lastly, epidemiological studies suggest that in hypoxemic patients, the number of quadrants involved has a strong prognostic value. The number of quadrants is more important than the location of the unilateral or bilateral nature of the involvement for the prognosis, and hypoxemic patients with unilateral lung injury should probably be considered as requiring lung protective ventilation as classical acute respiratory distress syndrome.

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Section: Definition/diagnostic Of Asymmetrical Acute Respiratory Dist...mentioning

confidence: 85%

Section: Airway Closure During Asymmetrical Lung Injury: Detection An...mentioning

confidence: 94%

Section: Airway Closure During Asymmetrical Lung Injury: Detection An...mentioning

confidence: 99%

Section: Definition/diagnostic Of Asymmetrical Acute Respiratory Dist...mentioning

confidence: 99%

Section: Definition/diagnostic Of Asymmetrical Acute Respiratory Dist...mentioning

confidence: 99%

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Asymmetrical Lung Injury: Management and Outcome

Bastia

Rozé

Brochard

2022

Semin Respir Crit Care Med

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Lung and diaphragm protective ventilation: a synthesis of recent data

Karageorgos

Proklou

Vaporidi

2022

Expert Review of Respiratory Medicine

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Fast artifact filtering algorithm for electrical resistivity tomography

Han

Lü

et al. 2023

Meas. Sci. Technol.

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Owing to the ill condition of electrical resistivity tomography and the measurement error of the hardware equipment, the reconstructed resistivity distribution image often contains artifacts of varying degrees. Other soft-field imaging technologies, such as electrical impedance tomography and electrical capacitance tomography also encounter artifacts. Artifacts interfere with the assessment of the real damaged area. To eliminate the influence of artifacts on the reconstructed image, a novel artifact elimination algorithm called the Fast Artifact Filtering (FAF) algorithm was proposed. Based on the calculation results of existing algorithms (such as the NOSER algorithm), the FAF algorithm can remove the damaged areas with low confidence from the potential damaged areas, and only retain the damaged areas with high confidence for final imaging. Several simulation models were used to test the effectiveness of the artifact elimination algorithm proposed in this study. The test results show that the number of artifacts in the final reconstructed image was significantly eliminated after the NOSER algorithm was combined with the FAF algorithm. In addition, when the number of finite element model division elements was 4802, the refresh time of a single image only increased by approximately 1ms. A structural health monitoring test for hollow structure is provided. The results show that the FAF also performs well on the measured voltage data.

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Electrical Impedance Tomography to Detect Airway Closure Heterogeneity in Asymmetrical Acute Respiratory Distress Syndrome

Cited by 8 publications

References 12 publications

Asymmetrical Lung Injury: Management and Outcome

Asymmetrical Lung Injury: Management and Outcome

Lung and diaphragm protective ventilation: a synthesis of recent data

Fast artifact filtering algorithm for electrical resistivity tomography

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