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Proceedings Paper

Setting ventilation parameters guided by electrical impedance tomography in an animal trial of acute respiratory distress syndrome
Author(s): Michael Czaplik; Ingeborg Biener; Steffen Leonhardt; Rolf Rossaint
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Paper Abstract

Since mechanical ventilation can cause harm to lung tissue it should be as protective as possible. Whereas numerous options exist to set ventilator parameters, an adequate monitoring is lacking up to date. The Electrical Impedance Tomography (EIT) provides a non-invasive visualization of ventilation which is relatively easy to apply and commercially available. Although there are a number of published measures and parameters derived from EIT, it is not clear how to use EIT to improve clinical outcome of e.g. patients suffering from acute respiratory distress syndrome (ARDS), a severe disease with a high mortality rate. On the one hand, parameters should be easy to obtain, on the other hand clinical algorithms should consider them to optimize ventilator settings. The so called Global inhomogeneity (GI) index bases on the fact that ARDS is characterized by an inhomogeneous injury pattern. By applying positive endexpiratory pressures (PEEP), homogeneity should be attained. In this study, ARDS was induced by a double hit procedure in six pigs. They were randomly assigned to either the EIT or the control group. Whereas in the control group the ARDS network table was used to set the PEEP according to the current inspiratory oxygen fraction, in the EIT group the GI index was calculated during a decremental PEEP trial. PEEP was kept when GI index was lowest. Interestingly, PEEP was significantly higher in the EIT group. Additionally, two of these animals died ahead of the schedule. Obviously, not only homogeneity of ventilation distribution matters but also limitation of over-distension.

Paper Details

Date Published: 13 March 2014
PDF: 7 pages
Proc. SPIE 9038, Medical Imaging 2014: Biomedical Applications in Molecular, Structural, and Functional Imaging, 90381Y (13 March 2014); doi: 10.1117/12.2043402
Show Author Affiliations
Michael Czaplik, Univ. Hospital RWTH Aachen (Germany)
RWTH Aachen Univ. (Germany)
Ingeborg Biener, Univ. Hospital RWTH Aachen (Germany)
Steffen Leonhardt, RWTH Aachen Univ. (Germany)
Rolf Rossaint, Univ. Hospital RWTH Aachen (Germany)

Published in SPIE Proceedings Vol. 9038:
Medical Imaging 2014: Biomedical Applications in Molecular, Structural, and Functional Imaging
Robert C. Molthen; John B. Weaver, Editor(s)

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