Monitoring lung impedance changes during long-term ventilator-induced lung injury ventilation using electrical impedance tomography

Physiol Meas. 2020 Oct 9;41(9):095011. doi: 10.1088/1361-6579/abb1fb.

Abstract

Objective: The target of this methodological evaluation was the feasibility of long-term monitoring of changes in lung conditions by time-difference electrical impedance tomography (tdEIT). In contrast to ventilation monitoring by tdEIT, the monitoring of end-expiratory (EELIC) or end-inspiratory (EILIC) lung impedance change always requires a reference measurement.

Approach: To determine the stability of the used Pulmovista 500® EIT system, as a prerequisite it was initially secured on a resistive phantom for 50 h. By comparing the slopes of EELIC for the whole lung area up to 48 h from 36 pigs ventilated at six positive end-expiratory pressure (PEEP) levels from 0 to 18 cmH2O we found a good agreement (range of r 2 = 0.93-1.0) between absolute EIT (aEIT) and tdEIT values. This justified the usage of tdEIT with its superior local resolution compared to aEIT for long-term determination of EELIC.

Main results: The EELIC was between -0.07 Ωm day-1 at PEEP 4 and -1.04 Ωm day-1 at PEEP 18 cmH2O. The complex local time pattern for EELIC was roughly quantified by the new parameter, centre of end-expiratory change (CoEEC), in equivalence to the established centre of ventilation (CoV). The ventrally located mean of the CoV was fairly constant in the range of 42%-46% of thorax diameter; however, on the contrary, the CoEEC shifted from about 40% to about 75% in the dorsal direction for PEEP levels of 14 and 18 cmH2O.

Significance: The observed shifts started earlier for higher PEEP levels. Changes of EELI could be precisely monitored over a period of 48 h by tdEIT on pigs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Electric Impedance
  • Exhalation
  • Monitoring, Physiologic*
  • Swine
  • Time Factors
  • Tomography*
  • Ventilator-Induced Lung Injury / diagnostic imaging*
  • Ventilator-Induced Lung Injury / physiopathology*