Electrical Impedance Tomography During Mechanical Ventilation.
Electrical impedance tomography (EIT) is a noninvasive, non-radiologic imaging modality that may be useful for the quantification of lung disorders and titration of mechanical ventilation. The principle of operation is based on changes in electrical conductivity that occur as a function of changes in lung volume during ventilation. EIT offers potentially important benefits over standard imaging modalities because the system is portable and non-radiologic and can be applied to patients for long periods of time. Rather than providing a technical dissection of the methods utilized to gather, compile, reconstruct, and display EIT images, the present article seeks to provide an overview of the clinical application of this technology as it relates to monitoring mechanical ventilation and providing decision support at the bedside. EIT has been shown to be useful in the detection of pneumothoraces, quantification of pulmonary edema and comparison of distribution of ventilation between different modes of ventilation and may offer superior individual titration of PEEP and other ventilator parameters compared with existing approaches. Although application of EIT is still primarily done within a research context, it may prove to be a useful bedside tool in the future. However, head-to-head comparisons with existing methods of mechanical ventilation titration in humans need to be conducted before its application in general ICUs can be recommended.
Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts. Brian.walsh@childrens.harvard.edu.
Brian K
BK
Walsh
Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts. Department of Bioengineering, Northeastern University, Boston, Massachusetts.
Craig D
CD
Smallwood
D017097:Electric Impedance; D006801:Humans; D008176:Lung Volume Measurements / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods*; D000067716:Point-of-Care Testing; D012121:Respiration, Artificial; D014054:Tomography / Q000379:methods*
electrical impedance tomography; lung imaging; mechanical ventilation; regional distribution of ventilation