Novel technologies to detect atelectotrauma in the injured lung.
Cyclical recruitment and derecruitment of lung parenchyma (R/D) remains a serious problem in ALI/ARDS patients, defined as atelectotrauma. Detection of cyclical R/D to titrate the optimal respiratory settings is of high clinical importance. Image-based technologies that are capable of detecting changes of lung ventilation within a respiratory cycle include dynamic computed tomography (dCT), synchrotron radiation computed tomography (SRCT), and electrical impedance tomography (EIT). Time-dependent intra-arterial oxygen tension monitoring represents an alternative approach to detect cyclical R/D, as cyclical R/D can result in oscillations of PaO₂ within a respiratory cycle. Continuous, ultrafast, on-line in vivo measurement of PaO₂ can be provided by an indwelling PaO₂ probe. In addition, monitoring of fast changes in SaO₂ by pulse oximetry technology at the bedside could also be used to detect those fast changes in oxygenation.
Shi
Chang
C
Department of Anesthesiology, Medical Center of the Johannes-Gutenberg-University, Mainz, Germany. shich08@hotmail.com
Boehme
Stefan
S
Hartmann
Erik K
EK
Markstaller
Klaus
K
D055371:Acute Lung Injury / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D003952:Diagnostic Imaging / Q000379:methods; D017097:Electric Impedance; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D010092:Oximetry; D011237:Predictive Value of Tests; D011379:Prognosis; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed