Integrating electrical impedance tomography and transpulmonary pressure monitoring to personalize PEEP in hypoxemic patients undergoing pressure support ventilation

Crit Care. 2022 Oct 18;26(1):314. doi: 10.1186/s13054-022-04198-4.

Abstract

Monitoring with electrical impedance tomography (EIT) during a decremental PEEP trial has been used to identify the PEEP that yields the optimal balance of pulmonary overdistension and collapse. This method is based on pixel-level changes in respiratory system compliance and depends on fixed or measured airway driving pressure. We developed a novel approach to quantify overdistension and collapse during pressure support ventilation (PSV) by integrating transpulmonary pressure and EIT monitoring and performed pilot tests in three hypoxemic patients. We report that our experimental approach is feasible and capable of identifying a PEEP that balances overdistension and collapse in intubated hypoxemic patients undergoing PSV.

Keywords: Electrical impedance tomography; Personalized positive end-expiratory pressure; Pressure support ventilation.

Publication types

  • Clinical Trial

MeSH terms

  • Electric Impedance* / therapeutic use
  • Humans
  • Hypoxia* / diagnostic imaging
  • Hypoxia* / therapy
  • Positive-Pressure Respiration* / methods
  • Tomography* / methods