Regional lung function testing in children using electrical impedance tomography

Vogt, Barbara; Löhr, Sarah; Zhao, Zhanqi; Falkenberg, Christian; Ankermann, Tobias; Weiler, Norbert; Frerichs, Inéz

doi:10.1002/ppul.23912

Cited by 13 publications

(13 citation statements)

References 38 publications

(86 reference statements)

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“…Nonsmokers The time-dependent functional information from PFT can be visualised by means of the regional lung function parameters t50, t75 and t90. This allows not only the detection of differences in ventilation distribution among several study groups, as shown in our current study, but also timely changes in ventilation distribution between two measuring times in one individual such as before and after exercise challenge or before and after administration of bronchodilators as already shown in small studies [10][11][12]. In one of the first studies on PFT and EIT we detected differences in spatial and temporal ventilation distribution between lung-healthy subjects and patients with COPD [6].…”

Section: Smokerssupporting

confidence: 80%

“…Despite smaller scan rates than conventional PFT dominated by spirometry and plethysmography, EIT delivered data at a scan rate of 33 images per second in the present study, in up to 836 regional values of a certain regional lung function parameter, such as FEV1,EIT in the examined thorax cross section. Conventional PFT provides only one value, such as global FEV1 measured at the airway opening [10,24].…”

Section: Exsmokersmentioning

confidence: 99%

“…EIT assesses the regional lung function and is able to identify ventilation heterogeneities directly in the examined region of the chest in spontaneously breathing subjects [8,9]. Because of its noninvasiveness, radiation-free measuring principle and easy bedside use, EIT can be applied at any age [10][11][12][13][14][15]. In order to correctly interpret the impairment of regional lung function and its development over time in patients with lung diseases, reference values of regional lung function parameters derived from a lung-healthy population are needed.…”

Section: Introductionmentioning

confidence: 99%

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Regional lung function in nonsmokers and asymptomatic current and former smokers

Vogt¹,

Deuß²,

Hennig³

et al. 2019

ERJ Open Res

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Electrical impedance tomography (EIT) is able to detect rapid lung volume changes during breathing. The aim of our observational study was to characterise the heterogeneity of regional ventilation distribution in lung-healthy adults by EIT and to detect the possible impact of tobacco consumption.A total of 219 nonsmokers, asymptomatic ex-smokers and current smokers were examined during forced full expiration using EIT. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC were determined in 836 EIT image pixels for the analysis of spatial and temporal ventilation distribution. Coefficients of variation (CVs) of these pixel values were calculated. Histograms and medians of FEV1/FVCEIT and times required to exhale 50%, 75%, 90% of FVCEIT (t50, t75 and t90) were generated.CV of FEV1/FVCEIT distinguished among all groups (mean±sd: nonsmokers 0.43±0.05, ex-smokers 0.52±0.09, smokers 0.62±0.16). Histograms of FEV1/FVCEIT differentiated between nonsmokers and the other groups (p<0.0001). Medians of t50, t75 and t90 showed the lowest values in nonsmokers. Median t90 separated all groups (median (interquartile range): nonsmokers 0.82 (0.67–1.15), ex-smokers 1.41 (1.03–2.21), smokers 1.91 (1.33–3.53)).EIT detects regional ventilation heterogeneity during forced expiration in healthy nonsmokers and its increase in asymptomatic former and current smokers. Therefore, EIT-derived reference values should only be collected from nonsmoking lung-healthy adults.

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Section: Smokerssupporting

confidence: 80%

Section: Exsmokersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional lung function in nonsmokers and asymptomatic current and former smokers

Vogt¹,

Deuß²,

Hennig³

et al. 2019

ERJ Open Res

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“…The core patient population that might benefit from chest EIT are critically ill patients treated in neonatal (Chatziioannidis et al, 2013;Miedema et al, 2013;Rossi et al, 2013;Hough et al, 2014;van der Burg et al, 2016) and paediatric intensive care units (Steinmann et al, 2013;Wilsterman et al, 2016;Lupton-Smith et al, 2017). Children suffering from chronic lung diseases like cystic fibrosis or asthma (Lehmann et al, 2016;Mueller et al, 2018;Ngo et al, 2018;Vogt et al, 2018;Roethlisberger et al, 2018), especially those in the preschool age that cannot reliably perform conventional forced spirometric pulmonary function tests, represent another large patient group where EIT might become clinically relevant.…”

Section: Introductionmentioning

confidence: 99%

Chest electrical impedance tomography measures in neonatology and paediatrics—a survey on clinical usefulness

Frerichs¹,

Becher²

2019

Physiol. Meas.

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Objective: Chest electrical impedance tomography (EIT) is currently applied in neonatal and paediatric patients mainly within clinical studies. The findings of these studies imply that lung monitoring using EIT provides valuable information on regional lung ventilation and aeration at the bedside that might improve the therapy and care of this fragile patient population. In view of this postulated future use of EIT in neonatology and paediatrics we have conducted an international survey to assess the perceived usefulness of several measures derived from EIT examinations. Approach: A questionnaire validating the clinical usefulness of 14 previously described EIT measures was designed and sent to 36 clinicians with previous experience with EIT in neonatal and paediatric patients. A numerical rating scale was used to assess the usefulness of each measure. Main results: 34 clinicians from 12 countries responded to the invitation and 32 filled in the questionnaire. The mean clinical and EIT experience (SD) of the respondents was 19.49.1 yr and 7.75.8 yr, respectively. The top-rated measures were the global inhomogeneity index, silent spaces, change in end-expiratory lung impedance and ventrodorsal centre of ventilation. The bottom-rated were the regional respiratory time constant, tidal volume normalised to ml, respiratory rate and heart rate on the last rank. Significance: The survey revealed that EIT measures characterizing the ventilation and aeration distribution and the degree of their heterogeneity were deemed particularly useful. Respiratory rate, heart rate and overall tidal volume were considered less useful probably because these parameters are already routinely assessed by other conventional methods.

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“…EIT has mainly been used in adult patients in the intensive care unit, but more recently investigators have applied EIT to the study of pediatric respiratory disease. Vogt et al assessed regional lung ventilation using EIT in healthy children at baseline and after an exercise challenge. They obtained spirometry and EIT data from 90 healthy children ages 3 to 16 years, and they compared their results to data from 3 patients with CF.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Pulmonology year in review 2018: Asthma, physiology/pulmonary function testing, and respiratory infections

Loughlin

Muston

et al. 2019

Pediatric Pulmonology

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Pediatric Pulmonology publishes original research, reviews, and case reports related to a wide range of children's respiratory disorders. In our “Year in Review” series, we summarize publications in our major topic areas from 2018, in the context of selected literature in these areas from other journals relevant to our discipline. This review covers selected articles on asthma, physiology/lung function testing, and respiratory infections.

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Regional lung function testing in children using electrical impedance tomography

Abstract: Global and regional lung functions were not affected by exercise in lung-healthy children. Exercise did not increase ventilation inhomogeneity. The obtained EIT-derived regional lung parameters can serve as reference values for future studies in children with lung diseases.

Cited by 13 publications

References 38 publications

Regional lung function in nonsmokers and asymptomatic current and former smokers

Regional lung function in nonsmokers and asymptomatic current and former smokers

Chest electrical impedance tomography measures in neonatology and paediatrics—a survey on clinical usefulness

Pediatric Pulmonology year in review 2018: Asthma, physiology/pulmonary function testing, and respiratory infections

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