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Clinical value of electrical impedance tomography (EIT) in the management of patients with acute respiratory failure: a single centre experience. | LitMetric

AI Article Synopsis

  • The study evaluated the use of electrical impedance tomography (EIT) in managing mechanical ventilation for patients with acute respiratory failure, focusing on how EIT-guided settings of positive end-expiratory pressure (PEEP) compared to standard clinical settings.
  • Conducted over a three-year period, the study included 54 EIT sessions in 41 patients, most of whom were on ECMO support, and found that EIT helped in individualizing PEEP settings but did not significantly change respiratory mechanics during adjustments.
  • Results indicated that patients with greater hypoxia were more frequently derecruited, while those with less hypoxia were overdistended, highlighting EIT's role as a valuable, non

Article Abstract

We will describe our clinical experience using electrical impedance tomography (EIT) in the management of mechanical ventilation in patients with acute respiratory failure and to determine to which extent EIT-guided positive end-expiratory pressure (PEEP) setting differed from clinically set values.We conducted a retrospective, observational cohort study performed in a hub centre for the treatment of acute respiratory failure and veno-venous extracorporeal membrane oxygenation (ECMO).Between January 2017 and December 2019, EIT was performed 54 times in 41 patients, not feasible only in one case because of signal instability. More than 50% was on veno-venous ECMO support. In 16 cases (30%), EIT was used for monitoring mechanical ventilation, i.e. to evaluate recruitability or sigh setting. In 37 cases (70%), EIT was used to set PEEP both with incremental (11 cases in nine patients) and decremental (26 cases, 18 patients) PEEP trial. Clinical PEEP before the decremental PEEP trial (PEEP) was 14.1 ± 3.4 cmH2O and clinical PEEP set by clinicians after the PEEP trial (PEEP) was 13.6 ± 3.1 (p = ns). EIT analyses demonstrated that more hypoxic patients were higher derecruited when compared to less hypoxic patients that were, on the contrary, more overdistended (p < 0.05). No acute effects of PEEP adjustment based on EIT on respiratory mechanics or regional EIT parameters modification were observed.The variability of EIT findings in our population confirmed the need to provide ventilation settings individually tailored and EIT was confirmed to be an optimal useful clinical bedside noninvasive tool to provide real-time monitoring of the PEEP effect and ventilation distribution.

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Source
http://dx.doi.org/10.1088/1361-6579/ac0e85DOI Listing

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