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Electrical Impedance Tomography as a monitoring tool during weaning from mechanical ventilation: an observational study during the spontaneous breathing trial. | LitMetric

AI Article Synopsis

  • Prolonged weaning from mechanical ventilation can lead to poor outcomes, making it crucial to identify the right time for weaning and extubation; the study investigates Electrical Impedance Tomography (EIT) as a monitoring technique to assist in this decision-making process.
  • In an observational study of 24 adult patients undergoing a T-piece spontaneous breathing trial (SBT), various EIT parameters were measured, revealing that significant changes occurred, particularly in end-expiratory lung impedance (EELI) and lung inhomogeneity, during SBT.
  • Results indicated that EIT could effectively assess lung ventilation changes, identifying high lung inhomogeneity during SBT failures; however, further research

Article Abstract

Background: Prolonged weaning from mechanical ventilation is associated with poor clinical outcome. Therefore, choosing the right moment for weaning and extubation is essential. Electrical Impedance Tomography (EIT) is a promising innovative lung monitoring technique, but its role in supporting weaning decisions is yet uncertain. We aimed to evaluate physiological trends during a T-piece spontaneous breathing trail (SBT) as measured with EIT and the relation between EIT parameters and SBT success or failure.

Methods: This is an observational study in which twenty-four adult patients receiving mechanical ventilation performed an SBT. EIT monitoring was performed around the SBT. Multiple EIT parameters including the end-expiratory lung impedance (EELI), delta Tidal Impedance (ΔZ), Global Inhomogeneity index (GI), Rapid Shallow Breathing Index (RSBI), Respiratory Rate (RR) and Minute Ventilation (MV) were computed on a breath-by-breath basis from stable tidal breathing periods.

Results: EELI values dropped after the start of the SBT (p < 0.001) and did not recover to baseline after restarting mechanical ventilation. The ΔZ dropped (p < 0.001) but restored to baseline within seconds after restarting mechanical ventilation. Five patients failed the SBT, the GI (p = 0.01) and transcutaneous CO (p < 0.001) values significantly increased during the SBT in patients who failed the SBT compared to patients with a successful SBT.

Conclusion: EIT has the potential to assess changes in ventilation distribution and quantify the inhomogeneity of the lungs during the SBT. High lung inhomogeneity was found during SBT failure. Insight into physiological trends for the individual patient can be obtained with EIT during weaning from mechanical ventilation, but its role in predicting weaning failure requires further study.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11044327PMC
http://dx.doi.org/10.1186/s12931-024-02801-6DOI Listing

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