Clinical implementation of electric impedance tomography in the treatment of ARDS: a single centre experience

Serge J. H. Heines*, Ulrich Strauch, Marcel C. G. van de Poll, Paul M. H. J. Roekaerts, Dennis C. J. J. Bergmans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Web of Science)

Abstract

To report on our clinical experience using EIT in individualized PEEP titration in ARDS. Using EIT assessment, we optimized PEEP settings in 39 ARDS patients. The EIT PEEP settings were compared with the physicians' PEEP settings and the PEEP settings according to the ARDS network. We defined a PEEP difference equal to or greater than 4cm H2O as clinically relevant. Changes in lung compliance and PaO2/FiO(2)-ratio were compared in patients with EIT-based PEEP adjustments and in patients with unaltered PEEP. In 28% of the patients, the difference in EIT-based PEEP and physician-PEEP was clinically relevant; in 36%, EIT-based PEEP and physician-PEEP were equal. The EIT-based PEEP disagreed with the PEEP settings according to the ARDS network. Adjusting PEEP based upon EIT led to a rapid increase in lung compliance and PaO2/FiO(2)-ratio. However, this increase was also observed in the group where the PEEP difference was less than 4cm H2O. We hypothesize that this can be attributed to the alveolar recruitment during the PEEP trial. EIT based individual PEEP setting appears to be a promising method to optimize PEEP in ARDS patients. The clinical impact, however, remains to be established.

Original languageEnglish
Pages (from-to)291-300
Number of pages10
JournalJournal of Clinical Monitoring and Computing
Volume33
Issue number2
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Electrical impedance tomography
  • Acute respiratory distress syndrome
  • Positive end expiratory pressure
  • Mechanical ventilation
  • END-EXPIRATORY PRESSURE
  • ACUTE RESPIRATORY-FAILURE
  • MECHANICAL VENTILATION
  • ALVEOLAR RECRUITMENT
  • LUNG
  • PEEP
  • TITRATION
  • DERECRUITMENT
  • ANESTHESIA
  • STRESS

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