Prolonged Continuous Monitoring of Regional Lung Function in Infants with Respiratory Failure

Abstract

Electrical impedance tomography (EIT) allows non-invasive and radiation-free monitoring of regional ventilation distribution and changes in end-expiratory lung volume in critically ill patients of all ages. In the vulnerable neonatal and pediatric population, EIT can be used to identify adverse events like atelectasis, pneumothorax and endotracheal tube malposition and potentially guide the personalized selection of ventilator settings. Previous studies have examined EIT in small patient groups during short measurement periods of only a few hours or less under highly controlled circumstances. What This Study Adds to the Field:In the Continuous Regional Analysis Device for Neonate Lungs (CRADL) project, we performed the first multi-center observational study on the use of EIT in critically ill neonates and young children with or at risk for respiratory failure. Including 200 patients, we demonstrated that continuous EIT monitoring for up to 72 hours is feasible, safe and can be used for continuous monitoring of ventilation distribution in neonates and infants in a routine clinical setting.

Lung Imaging Acquisition with Electrical Impedance Tomography: Tackling Common Pitfalls

“…Research addressing the clinical impact of electrical impedance tomography applications is becoming more frequent. 62,63 However, a comprehensive understanding of the pitfalls of monitoring, data processing, and data interpretation in electrical impedance tomography is necessary to ensure accurate and reliable conclusions. Electrical impedance tomography is radiation-free and noninvasive and allows multiple and prolonged measurements.…”

Regional ventilation distribution before and after laparoscopic lung parenchymal resection

“…With this rationale it provides continuous images of pulmonary ventilation and shows regional ventilation change. In the context of peri-operative procedures, EIT has been proposed to assess the regional lung functions (Lasarow et al 2021, Becher et al 2022, ventilator settings during one-lung ventilation (Liu et al 2019, Zha et al 2023, peri-operative ventilation distribution and recovery after thoracic surgery (Zhao et al 2021, Lin et al 2022, pulmonary rehabilitation program and inspiratory muscle activities (Li et al 2023). In a previous study, we observed that regional ventilation distribution might not recover easily even after minimally invasive surgery (Zhao et al 2021).…”

ERS International Congress 2022: highlights from the Paediatrics Assembly

“…Lung ultrasound is becoming much more widely available and accessible, and can be used as a diagnostic tool, to guide respiratory support, and predict outcomes [ 52 , 53 ]. Electrical impedance tomography is an up-and-coming non-invasive method used to define pulmonary physiology and describe regional lung aeration and mechanics, and to guide the titration of positive end-expiratory pressure [ 54 , 55 ]. Additionally, the forced oscillation technique or respiratory oscillometry can be used to provide an assessment of respiratory reactance and resistance, and can be applied during intubation and spontaneous breathing, to identify the requirement for surfactant therapy and predict preterm respiratory outcomes [ 56 , 57 ].…”