Electrical Impedance Tomography to Titrate PEEP at Bedside in ARDS

Barbas, C S; Amato, Marcelo B. P.

doi:10.4187/respcare.10360

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Several techniques have been used to determine the optimal PEEP ( 6 - 10 ). For example, electrical impedance tomography (EIT) can be performed at the bedside ( 5 , 11 , 12 ). However, the application of this technique requires special training, which increases the workload of the care team, and the cost efficiency of this procedure remains to be determined.…”

Section: Introductionmentioning

confidence: 99%

Optimal positive end-expiratory pressure obtained with titration of a fraction of inspiratory oxygen: a randomized controlled clinical trial

Gao¹,

Yang²,

Pan³

et al. 2023

Ann Transl Med

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Background Optimal intraoperative positive end-expiratory pressure (PEEP) improves patient outcomes. Pulse oximetry has been used to determine the lung opening and closing pressures. Therefore, we hypothesized that intraoperative optimal PEEP obtained by titrating inspiratory oxygen fraction (FiO 2 ) guided with pulse oximetry could improve perioperative oxygenation. Methods Forty-six males undergoing elective robotic-assisted laparoscopic prostatectomy were randomly assigned to either the optimal PEEP group (group O; n=23) or the fixed PEEP of 5 cmH 2 O group (group C; n=23). Optimal PEEP, defined as the PEEP with the lowest FiO 2 or 0.21 to maintain SpO 2 greater than or equal to 95%, was obtained in both groups after placing the patients in the Trendelenburg position and conducting intraperitoneal insufflation. Optimal PEEP was maintained for patients in group O. A PEEP of 5 cmH 2 O intraoperatively was maintained for patients in group C. Both groups were extubated in a semisitting position once the extubation criteria were met. The primary outcome was the arterial oxygen partial pressure (PaO 2 ) divided by the inspiratory oxygen fraction (FiO 2 ) prior to extubation. The secondary outcome was the incidence of postoperative hypoxemia (SpO 2 less than 92% on room air after extubation) in the postanesthesia care unit (PACU). Results The median optimal PEEP was 16 cmH 2 O (IQR 12–18). The PaO 2 /FiO 2 prior to extubation was significantly higher in group O than in group C (77.0±4.9 kPa vs. 60.6±5.9 kPa; P=0.04). PaO 2 /FiO 2 was also significantly higher in group O 30 minutes after extubation (57.6±1.9 vs. 46.6±1.8 kPa; P=0.01). The incidence of hypoxemia on room air in the PACU was significantly lower in group O than in group C (4.3% vs. 30.4%; P=0.02). Conclusions Intraoperative optimal PEEP can be achieved by a titration of FiO 2 guided with SpO 2 . Maintaining intraoperative optimal PEEP improves intraoperative oxygenation and reduces the incidence of postoperative hypoxemia. Trial Registration The study was prospectively registered on September 10, 2021, in the Chinese Clinical Trial Registry (identifier: ChiCTR2100051010).

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Section: Introductionmentioning

confidence: 99%

Optimal positive end-expiratory pressure obtained with titration of a fraction of inspiratory oxygen: a randomized controlled clinical trial

Gao¹,

Yang²,

Pan³

et al. 2023

Ann Transl Med

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Electrical impedance tomography: Usefulness for respiratory physiotherapy in critical illnesses

Arriagada,

Bachmann,

San Martin

et al. 2024

Medicina Intensiva (English Edition)

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Posterior Approximate Clustering-Based Sensitivity Matrix Decomposition for Electrical Impedance Tomography

Wang,

Sun,

2024

Sensors

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This paper introduces a sensitivity matrix decomposition regularization (SMDR) method for electric impedance tomography (EIT). Using k-means clustering, the EIT-reconstructed image can be divided into four clusters, derived based on image features, representing posterior information. The sensitivity matrix is then decomposed into distinct work areas based on these clusters. The elimination of smooth edge effects is achieved through differentiation of the images from the decomposed sensitivity matrix and further post-processing reliant on image features. The algorithm ensures low computational complexity and avoids introducing extra parameters. Numerical simulations and experimental data verification highlight the effectiveness of SMDR. The proposed SMDR algorithm demonstrates higher accuracy and robustness compared to the typical Tikhonov regularization and the iterative penalty term-based regularization method (with an improvement of up to 0.1156 in correlation coefficient). Moreover, SMDR achieves a harmonious balance between image fidelity and sparsity, effectively addressing practical application requirements.

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Electrical Impedance Tomography to Titrate PEEP at Bedside in ARDS

Cited by 3 publications

References 12 publications

Optimal positive end-expiratory pressure obtained with titration of a fraction of inspiratory oxygen: a randomized controlled clinical trial

Optimal positive end-expiratory pressure obtained with titration of a fraction of inspiratory oxygen: a randomized controlled clinical trial

Electrical impedance tomography: Usefulness for respiratory physiotherapy in critical illnesses

Posterior Approximate Clustering-Based Sensitivity Matrix Decomposition for Electrical Impedance Tomography

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