Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit.

Electrical Impedance Tomography (EIT) is a groundbreaking, non-invasive, and radiation-free imaging technique for continuous, real-time ventilation monitoring. It also has an application in pulmonary perfusion monitoring. EIT quantifies ventilation and perfusion patterns across the lung from the measurement and processing of impedance changes in the thorax.

The pleural gradient does not reflect the superimposed pressure in patients with class III obesity.

Background: The superimposed pressure is the primary determinant of the pleural pressure gradient. Obesity is associated with elevated end-expiratory esophageal pressure, regardless of lung disease severity, and the superimposed pressure might not be the only determinant of the pleural pressure gradient. The study aims to measure partitioned respiratory mechanics and superimposed pressure in a cohort of patients admitted to the ICU with and without class III obesity (BMI ≥ 40 kg/m), and to quantify the amount of thoracic adipose tissue and muscle through advanced imaging techniques.

First real-time imaging of bronchoscopic lung volume reduction by electrical impedance tomography.

Background: Bronchoscopic lung volume reduction (BLVR) with one-way endobronchial valves (EBV) has better outcomes when the target lobe has poor collateral ventilation, resulting in complete lobe atelectasis. High-inspired oxygen fraction (FO) promotes atelectasis through faster gas absorption after airway occlusion, but its application during BLVR with EBV has been poorly understood. We aimed to investigate the real-time effects of FO on regional lung volumes and regional ventilation/perfusion by electrical impedance tomography (EIT) during BLVR with EBV.

Individualised positive end-expiratory pressure titrated intra-operatively by electrical impedance tomography optimises pulmonary mechanics and reduces postoperative atelectasis: A randomised controlled trial.

Background: A protective intra-operative lung ventilation strategy has been widely recommended for laparoscopic surgery. However, there is no consensus regarding the optimal level of positive end-expiratory pressure (PEEP) and its effects during pneumoperitoneum. Electrical impedance tomography (EIT) has recently been introduced as a bedside tool to monitor lung ventilation in real-time.

Regional lung perfusion using different indicators in electrical impedance tomography.

Management of acute respiratory distress syndrome (ARDS) is classically guided by protecting the injured lung and mitigating damage from mechanical ventilation. Yet the natural history of ARDS is also dictated by disruption in lung perfusion. Unfortunately, diagnosis and treatment are hampered by the lack of bedside perfusion monitoring.

New Graduate Respiratory Therapists' Perceptions of Their Transition to Practice.

Background: The emerging challenges in the healthcare system require a vision for the future of respiratory care to ensure a successful transition to practice for new graduate respiratory therapists (RT). The nursing profession has recognized the need to acknowledge the successes and failures of graduates' transition to practice so that these programs can be continuously improved. The challenge is in identifying aspects of the transition to practice that may improve job satisfaction, retention, professional development, and patient care for RTs.

Pleural Pressure Targeted Positive Airway Pressure Improves Cardiopulmonary Function in Spontaneously Breathing Patients With Obesity.

Background: Increased pleural pressure affects the mechanics of breathing of people with class III obesity (BMI > 40 kg/m).

Research Question: What are the acute effects of CPAP titrated to match pleural pressure on cardiopulmonary function in spontaneously breathing patients with class III obesity?

Study Design And Methods: We enrolled six participants with BMI within normal range (control participants, group I) and 12 patients with class III obesity (group II) divided into subgroups: IIa, BMI of 40 to 50 kg/m; and IIb, BMI of ≥ 50 kg/m. The study was performed in two phases: in phase 1, participants were supine and breathing spontaneously at atmospheric pressure, and in phase 2, participants were supine and breathing with CPAP titrated to match their end-expiratory esophageal pressure in the absence of CPAP.

Effect of Intensive vs Moderate Alveolar Recruitment Strategies Added to Lung-Protective Ventilation on Postoperative Pulmonary Complications: A Randomized Clinical Trial.

Importance: Perioperative lung-protective ventilation has been recommended to reduce pulmonary complications after cardiac surgery. The protective role of a small tidal volume (VT) has been established, whereas the added protection afforded by alveolar recruiting strategies remains controversial.

Objective: To determine whether an intensive alveolar recruitment strategy could reduce postoperative pulmonary complications, when added to a protective ventilation with small VT.