Mechanical ventilation guided by electrical impedance tomography in pediatric acute respiratory distress syndrome

Dmytrowich, Jeffrey; Holt, Tanya; Schmid, Karen; Hansen, Gregory

doi:10.1007/s10877-017-0048-5

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…There was also an increase in static pulmonary compliance which may be related to a reduction in mortality since it is necessary to have a lower pressure value used in the airway to ventilate the patient, in this case there is less lung damage resulting from invasive mechanical ventilation 13 . Improvement in regional ventilation was also observed in the research participants, corroborating a case study in which an 11-year-old girl diagnosed with acute respiratory distress syndrome also demonstrated a significant improvement in regional ventilation after the alveolar recruitment maneuver 14 . Another factor found in this study was the reduction of alveolar overdistension, which according to a study by Sahetya et al 15 is related to a high risk of lung injury.…”

Section: Discussionsupporting

confidence: 86%

Titration of positive end-expiratory pressure with electrical impedance tomography in pediatrics

Carvalho¹,

Azevedo²,

Mello³

et al. 2022

ASSOBRAFIR Ciênc

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Background: Electrical impedance tomography (EIT) is widely used in the practice of patients with respiratory distress syndrome (ARDS), but little is known about the determination of adequate positive end-expiratory pressure (PEEP) in the pediatric intensive care unit. Aim: Evaluating the effects of titration of PEEP with EIT after alveolar recruitment in children with ARDS on ventilatory variables and blood gas analysis. Methods: This is a longitudinal analytical study carried out in the pediatric intensive care unit. The study included 5 patients diagnosed with ARDS, aged between 6 and 11 years and had an indication for alveolar recruitment maneuver (RM). The EIT belt was posicionated around the sternum and the ventilatory variables were collected (compliance, regional ventilation, driving pressure, alveolar overdistension, alveolar collapse and PEEP titration) and blood gas analysis. The RM was performed in steps, then PEEP titration was performed with the help of the EIT. Results: There was a significant improvement in the ventilatory variables and blood gas analysis of the participants after PEEP titration. The parameters that most changed the pre-and posttitration values were pulmonary compliance (p<0.05), alveolar overdistension (p<0.05), partial pressure of carbon dioxide (p<0.01), blood pressure of oxygen and arterial oxygen saturation (p<0.05). Conclusion: Titration of PEEP with the aid of EIT is safety, improving ventilation and basic acid balance in children with ARDS.

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Section: Discussionsupporting

confidence: 86%

Titration of positive end-expiratory pressure with electrical impedance tomography in pediatrics

Carvalho¹,

Azevedo²,

Mello³

et al. 2022

ASSOBRAFIR Ciênc

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“…We will also record the vital sign values including blood pressures, heart rates, oxygen saturations, respiratory rate, temperature and neurological status, including patient comfort level, oxygen saturation and work of breathing. Estimated regional lung volume and other parameters measured by EIT 12–14 and the values of EtCO 2 and its waveform will also be collected.…”

Section: Methodsmentioning

confidence: 99%

Incremental effect of non-invasive oscillating device on chest physiotherapy in critically ill children: a cross-over randomised trial

et al. 2020

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IntroductionChest physiotherapy (CPT) and intrathoracic percussion ventilation have been recognised as to encourage dislodging the secretions; nonetheless, the tolerance to the procedure and its efficiency have not been proven to be sufficient.Method and analysesThis study aims to examine the tolerance, feasibility and physiological effects in airway clearance by using a novel extrathoracic non-invasive oscillating transducer device (NIOD) in critically ill children. A two-stage cross-over randomised controlled study in a paediatric intensive care unit in a Canadian Academic Children’s Hospital will be applied. Children under 24 months old, for whom CPT is prescribed for airway clearance, will be included. The study consists of two stages; (1) Stage 1 ‘Frequency Level’: we will apply two different frequencies of the NIOD (40 Hz vs 60 Hz) for 12 min each, on each patient 3 hours apart, and (2) Stage 2 ‘NIOD versus CPT’: we will implement NIOD and CPT alternatingly for 3 hours apart. The order of the procedures will be randomly allocated for each case. We will compare the average Δchanges of tidal lung volume measured by a 3D imaging system and regional lung functions using electrical impedance tomography, between the two different frequencies and between the NIOD periods and the CPT periods. We will also examine tolerance by seeing COMFORT Scales and related complications during the procedures. We estimate necessary sample size as 6 for each arm (Total 12 cases) for stage 1 and 48 cases for Stage 2, with power of 0.8 and alpha of 0.05.Ethics and disseminationThis study has been approved by the Health Research Ethics Board of University of Montreal, Canada (REB number: 2020-2471). We will disseminate our findings through peer-reviewed publications and conference presentations in paediatric or/and critical care fields.Trial registration numberClinicalTrials.gov Registry (NCT03821389).

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“…The introduction of EIT in pediatric ARDS (pARDS) is discussed by Dmytrowich et al [42] who wrote a case report dealing with PEEP optimization in a 11 years old patient. The cause of ARDS was influenza A pneumonia and her status was characterized by hypoxemia, acidosis and necessity of mechanical ventilation.…”

Section: Lung Imagingmentioning

confidence: 99%

Journal of Clinical Monitoring and Computing 2018–2019 end of year summary: respiration

Karbing

Perchiazzi

Rees

et al. 2020

J Clin Monit Comput

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This paper reviews 28 papers or commentaries published in Journal of Clinical Monitoring and Computing in 2018 and 2019, within the field of respiration. Papers were published covering endotracheal tube cuff pressure monitoring, ventilation and respiratory rate monitoring, lung mechanics monitoring, gas exchange monitoring, CO 2 monitoring, lung imaging, and technologies and strategies for ventilation management.

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Mechanical ventilation guided by electrical impedance tomography in pediatric acute respiratory distress syndrome

Cited by 11 publications

References 20 publications

Titration of positive end-expiratory pressure with electrical impedance tomography in pediatrics

Titration of positive end-expiratory pressure with electrical impedance tomography in pediatrics

Incremental effect of non-invasive oscillating device on chest physiotherapy in critically ill children: a cross-over randomised trial

Journal of Clinical Monitoring and Computing 2018–2019 end of year summary: respiration

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