title: Influence of torso and arm positions on chest examinations by electrical impedance tomography.
abstract: Electrical impedance tomography (EIT) is increasingly used in patients suffering from respiratory disorders during pulmonary function testing (PFT). The EIT chest examinations often take place simultaneously to conventional PFT during which the patients involuntarily move in order to facilitate their breathing. Since the influence of torso and arm movements on EIT chest examinations is unknown, we studied this effect in 13 healthy subjects (37  ±  4 years, mean age  ±  SD) and 15 patients with obstructive lung diseases (72  ±  8 years) during stable tidal breathing. We carried out the examinations in an upright sitting position with both arms adducted, in a leaning forward position and in an upright sitting position with consecutive right and left arm elevations. We analysed the differences in EIT-derived regional end-expiratory impedance values, tidal impedance variations and their spatial distributions during all successive study phases. Both the torso and the arm movements had a highly significant influence on the end-expiratory impedance values in the healthy subjects (p  =  0.0054 and p  <  0.0001, respectively) and the patients (p  <  0.0001 in both cases). The global tidal impedance variation was affected by the torso, but not the arm movements in both study groups (p  =  0.0447 and p  =  0.0418, respectively). The spatial heterogeneity of the tidal ventilation distribution was slightly influenced by the alteration of the torso position only in the patients (p  =  0.0391). The arm movements did not impact the ventilation distribution in either study group. In summary, the forward torso movement and the arms' abduction exert significant effects on the EIT waveforms during tidal breathing. We recommend strict adherence to the upright sitting position during PFT when EIT is used.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Vogt
authors.forename: L
authors.initials: L
authors.lastname: Mendes
authors.forename: I
authors.initials: I
authors.lastname: Chouvarda
authors.forename: E
authors.initials: E
authors.lastname: Perantoni
authors.forename: E
authors.initials: E
authors.lastname: Kaimakamis
authors.forename: T
authors.initials: T
authors.lastname: Becher
authors.forename: N
authors.initials: N
authors.lastname: Weiler
authors.forename: V
authors.initials: V
authors.lastname: Tsara
authors.forename: R P
authors.initials: RP
authors.lastname: Paiva
authors.forename: N
authors.initials: N
authors.lastname: Maglaveras
authors.forename: I
authors.initials: I
authors.lastname: Frerichs
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000000981:diagnostic imaging / Q000502:physiology / Q000503:physiopathology; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology; D056888:Patient Positioning / Q000379:methods*; D011187:Posture / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology; D012119:Respiration; D014054:Tomography / Q000379:methods*; D060726:Torso / Q000000981:diagnostic imaging* / Q000502:physiology / Q000503:physiopathology