Lung Recruitment and Pendelluft Resolution after Less Invasive Surfactant Administration in a Preterm Infant

Gonçalves‐Ferri, Walusa Assad; Rossi, Felipe S.; Costa, Eduardo L. V.; Corrêa, Leticia C.; Iope, Daniela; Pacce, Pedro Dalla; Martins-Celini, F.P.; Bernardes, Ayla; Ribeiro, M. C. N.; Amato, Marcelo B. P.

doi:10.1164/rccm.201912-2439le

Cited by 5 publications

(5 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since the first report of "occult pendelluft" phenomenon in anesthetized pigs with acute lung injury and a patient with acute respiratory distress syndrome (ARDS) in 2013 [3], EIT has been increasingly used to detect the pendelluft in critically ill patients [14][15][16][17]. At least two studies tried to quantitatively assess the gas volume subjected to pendelluft and moving within the lungs through [9] introduced a method to detect the amplitude of pendelluft by comparing the sum of all pixel TIV with the global TIV, and expressed it as percent, where 1% of pendelluft amplitude was equal to 1 mL pendelluft volume per 100 mL tidal volume.…”

Section: Definition and Prevalence Of Pendelluftmentioning

confidence: 99%

Prevalence and prognosis of respiratory pendelluft phenomenon in mechanically ventilated ICU patients with acute respiratory failure: a retrospective cohort study

Chi

Zhao

Frerichs³

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

Background Respiratory pendelluft phenomenon, defined as intrapulmonary gas redistribution caused by asynchronous alveolar ventilation, could be potentially harmful by inducing lung injury. The aim of the present study was to investigate its prevalence and prognosis in intensive care unit (ICU) patients with acute respiratory failure (ARF). Methods This was a retrospective observational study on 200 mechanically ventilated ARF patients treated in a tertiary ICU. The presence of pendelluft was determined using electrical impedance tomography (EIT) within 48 h after admission. Its amplitude was defined as the impedance difference between the sum of all regional tidal impedance variation and the global tidal impedance variation. A value above 2.5% (the 95th percentile from 30 healthy volunteers) was considered confirmative for its occurrence. Results Pendelluft was found in 61 patients (39 in 94 patients with spontaneous breathing, 22 in 106 receiving controlled ventilation), with an overall prevalence of 31%. Existence of spontaneous breathing and higher global inhomogeneity index were associated with pendelluft. Patients with pendelluft had a longer ICU length of stay [10 (6, 14) vs. 7 (4, 11) days; median (lower, upper quartile); p = 0.022] and shorter 14-day ventilator-free days [8 (1, 10) vs. 10 (6, 12) days; p = 0.015]. Subgroup survival analysis suggested the association between pendelluft and longer ventilation duration, which was significant only in patients with PaO2/FiO2 ratio below 200 mmHg (log-rank p = 0.042). ICU mortality did not differ between the patients with and without pendelluft. Conclusions Respiratory pendelluft occurred often in our study group and it was associated with longer ventilation duration. Early recognition of this phenomenon should trigger interventions aimed at alleviating pendelluft.

show abstract

Section: Definition and Prevalence Of Pendelluftmentioning

confidence: 99%

Prevalence and prognosis of respiratory pendelluft phenomenon in mechanically ventilated ICU patients with acute respiratory failure: a retrospective cohort study

Chi

Zhao

Frerichs³

et al. 2022

Ann. Intensive Care

View full text Add to dashboard Cite

show abstract

“…54,[56][57][58][59][60] Potential advantages of LISA/MIST compared with standard surfactant via ETTwhen performed by experienced proceduralists-comprise the avoidance of positive pressure ventilation while providing similar effectiveness of surfactant deposition as compared with ETT, risk reduction of intubation trauma by using small diameter catheters for surfactant administration, maintenance of physiological larynx and glottis function, and support of physiological adaptation after birth, including lung recruitment, circulation, and regional tissue oxygenation. [61][62][63][64][65][66][67][68][69][70] Of note, in units practicing LISA and MIST, the procedure is considered as one part of a whole bundle of "less intensive or less invasive support measures," including delayed cord clamping, avoidance of hypothermia and discomfort, and the acceptance of positive endexpiratory pressure levels of 8 cm H 2 0 or greater, as well as the early initiation of caffeine. [71][72][73]…”

Section: If We Cannot Diagnose Rds Accurately and Early Can We Minimi...mentioning

confidence: 99%

Noninvasive Ventilation and Exogenous Surfactant in Times of Ever Decreasing Gestational Age: How Do We Make the Most of These Tools?

Wright

Glaser

Speer

et al. 2022

The Journal of Pediatrics

View full text Add to dashboard Cite

“…Recently EIT published data depicted self-inflicted lung injury mechanism, named “ Pendelluft ”, in a P-ARDS infant and in a preterm infant treated with minimally invasive surfactant therapy [ 20 , 21 ]. In those low compliance respiratory illness, EIT can monitor changes in air distribution and detect the lung recruitment at the bedside, as was already reported in adults both in the ICU and during anesthesia [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Electrical impedance tomography in pediatric patients with COVID-19, the first reports

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction Electrical impedance tomography (EIT) is a noninvasive, radiation-free, bedside tool to monitor ventilation distribution in real time. Objective To evaluate, in pediatric COVID-19 patients, the ventilation distribution using EIT and compare it to thoracic computed tomography (TCT) or chest radiograph results obtained in these patients. Methods This was a prospective, observational clinical study including pediatric patients admitted to the intensive care unit of a private hospital. The patients monitored with EIT tested positive for COVID-19 and were submitted to the previously mentioned radiation exams. EIT monitoring lasted 15 min and no sedation was used. Results Six patients were included in this study. The main differences observed in the EIT were in the right-left distribution and were compatible with the morphological changes found in the TCT or radiograph images due to COVID-19 infection. Conclusion We conclude that EIT is ready to investigate the ventilatory profile present at different lung diseases, including COVID-19, and might postpone or mitigate the need of repeated ionizing radiation exams in the pediatric population, although larger pediatric cohorts comparing to standard radiological imaging are needed.

show abstract

Lung Recruitment and Pendelluft Resolution after Less Invasive Surfactant Administration in a Preterm Infant

Cited by 5 publications

References 8 publications

Prevalence and prognosis of respiratory pendelluft phenomenon in mechanically ventilated ICU patients with acute respiratory failure: a retrospective cohort study

Prevalence and prognosis of respiratory pendelluft phenomenon in mechanically ventilated ICU patients with acute respiratory failure: a retrospective cohort study

Noninvasive Ventilation and Exogenous Surfactant in Times of Ever Decreasing Gestational Age: How Do We Make the Most of These Tools?

Electrical impedance tomography in pediatric patients with COVID-19, the first reports

Contact Info

Product

Resources

About