Bedside Breath-Wise Visualization of Bronchospasm by Electrical Impedance Tomography Could Improve Perioperative Patient Safety: A Case Report.
Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Electrical impedance tomography (EIT), a new noninvasive technique, can potentially identify bronchospasms by determining regional expiratory time constants (τ) for each one of the pixels of a functional EIT image. We present the first clinical case that highlights the potential of breath-wise EIT-based τ images of the lung to quickly identify bronchospasm at the bedside, which could improve perioperative patient management and safety.
From the *Pediatric Intensive Care Unit, Hospital Universitario La Paz, Madrid, ES, Spain; †Department of Pediatrics, Medical School, Universidad Autónoma de Madrid, ES, Spain; ‡Swisstom AG, Medical Research, Landquart, CH, Switzerland; and §Pediatric Anestesia and Reanimation Unit, Hospital Universitario La Paz, Madrid, ES, Spain.
Pedro
P
de la Oliva
Andreas D
AD
Waldmann
Stephan H
SH
Böhm
Cristina
C
Verdú-Sánchez
Antonio
A
Pérez-Ferrer
Elena
E
Alvarez-Rojas
D000293:Adolescent; D001986:Bronchial Spasm / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D016084:Bronchoconstriction; D017097:Electric Impedance; D045853:Exhalation; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D000067716:Point-of-Care Testing; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012121:Respiration, Artificial; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*