Dynamic relative regional lung strain estimated by computed tomography and electrical impedance tomography in ARDS patients.
Acute respiratory distress syndrome
Computed tomography
Electrical impedance tomography
Strain
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
24 11 2023
24 11 2023
Historique:
received:
17
08
2023
accepted:
18
11
2023
medline:
27
11
2023
pubmed:
25
11
2023
entrez:
24
11
2023
Statut:
epublish
Résumé
In the acute distress respiratory syndrome (ARDS), specific lung regions can be exposed to excessive strain due to heterogeneous disease, gravity-dependent lung collapse and injurious mechanical ventilation. Computed tomography (CT) is the gold standard for regional strain assessment. An alternative tool could be the electrical impedance tomography (EIT). We aimed to determine whether EIT-based methods can predict the dynamic relative regional strain (DRRS) between two levels of end-expiratory pressure (PEEP) in gravity-non-dependent and dependent lung regions. Fourteen ARDS patients underwent CT and EIT acquisitions (at end-inspiratory and end-expiratory) at two levels of PEEP: a low-PEEP based on ARDS-net strategy and a high-PEEP titrated according to EIT. Three EIT-based methods for DRRS were compared to relative CT-based strain: (1) the change of the ratio between EIT ventilation and end-expiratory lung impedance in arbitrary units ([ΔZ The DRRS assessed by (ΔZ Changes in DRRS during a PEEP trial in ARDS patients could be monitored using EIT, based on changes in ΔZ
Sections du résumé
BACKGROUND
In the acute distress respiratory syndrome (ARDS), specific lung regions can be exposed to excessive strain due to heterogeneous disease, gravity-dependent lung collapse and injurious mechanical ventilation. Computed tomography (CT) is the gold standard for regional strain assessment. An alternative tool could be the electrical impedance tomography (EIT). We aimed to determine whether EIT-based methods can predict the dynamic relative regional strain (DRRS) between two levels of end-expiratory pressure (PEEP) in gravity-non-dependent and dependent lung regions.
METHODS
Fourteen ARDS patients underwent CT and EIT acquisitions (at end-inspiratory and end-expiratory) at two levels of PEEP: a low-PEEP based on ARDS-net strategy and a high-PEEP titrated according to EIT. Three EIT-based methods for DRRS were compared to relative CT-based strain: (1) the change of the ratio between EIT ventilation and end-expiratory lung impedance in arbitrary units ([ΔZ
RESULTS
The DRRS assessed by (ΔZ
CONCLUSION
Changes in DRRS during a PEEP trial in ARDS patients could be monitored using EIT, based on changes in ΔZ
Identifiants
pubmed: 38001485
doi: 10.1186/s13054-023-04748-4
pii: 10.1186/s13054-023-04748-4
pmc: PMC10668403
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
457Subventions
Organisme : Fondo Nacional de Desarrollo Científico y Tecnológico
ID : 1161510
Informations de copyright
© 2023. The Author(s).
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