Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond”
Abstract Mechanical ventilation is a life-saving technology, but it can also inadvertently induce lung injury and increase morbidity and mortality. Currently, there is no easy method of assessing the impact that ventilator settings have on the degree of lung inssflation. Computed tomography (CT), th...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s44158-022-00055-6 |
| _version_ | 1811249906489229312 |
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| author | Michela Rauseo Elena Spinelli Nicolò Sella Douglas Slobod Savino Spadaro Federico Longhini Antonino Giarratano Cinnella Gilda Tommaso Mauri Paolo Navalesi SIAARTI Study Group |
| author_facet | Michela Rauseo Elena Spinelli Nicolò Sella Douglas Slobod Savino Spadaro Federico Longhini Antonino Giarratano Cinnella Gilda Tommaso Mauri Paolo Navalesi SIAARTI Study Group |
| author_sort | Michela Rauseo |
| collection | DOAJ |
| description | Abstract Mechanical ventilation is a life-saving technology, but it can also inadvertently induce lung injury and increase morbidity and mortality. Currently, there is no easy method of assessing the impact that ventilator settings have on the degree of lung inssflation. Computed tomography (CT), the gold standard for visually monitoring lung function, can provide detailed regional information of the lung. Unfortunately, it necessitates moving critically ill patients to a special diagnostic room and involves exposure to radiation. A technique introduced in the 1980s, electrical impedance tomography (EIT) can non-invasively provide similar monitoring of lung function. However, while CT provides information on the air content, EIT monitors ventilation-related changes of lung volume and changes of end expiratory lung volume (EELV). Over the past several decades, EIT has moved from the research lab to commercially available devices that are used at the bedside. Being complementary to well-established radiological techniques and conventional pulmonary monitoring, EIT can be used to continuously visualize the lung function at the bedside and to instantly assess the effects of therapeutic maneuvers on regional ventilation distribution. EIT provides a means of visualizing the regional distribution of ventilation and changes of lung volume. This ability is particularly useful when therapy changes are intended to achieve a more homogenous gas distribution in mechanically ventilated patients. Besides the unique information provided by EIT, its convenience and safety contribute to the increasing perception expressed by various authors that EIT has the potential to be used as a valuable tool for optimizing PEEP and other ventilator settings, either in the operative room and in the intensive care unit. The effects of various therapeutic interventions and applications on ventilation distribution have already been assessed with the help of EIT, and this document gives an overview of the literature that has been published in this context. |
| first_indexed | 2024-04-12T15:55:45Z |
| format | Article |
| id | doaj.art-0f9aeebf6f1e4488ae0e31e094ecbfa8 |
| institution | Directory Open Access Journal |
| issn | 2731-3786 |
| language | English |
| last_indexed | 2024-04-12T15:55:45Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj.art-0f9aeebf6f1e4488ae0e31e094ecbfa82022-12-22T03:26:22ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862022-06-012111410.1186/s44158-022-00055-6Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond”Michela Rauseo0Elena Spinelli1Nicolò Sella2Douglas Slobod3Savino Spadaro4Federico Longhini5Antonino Giarratano6Cinnella Gilda7Tommaso Mauri8Paolo Navalesi9SIAARTI Study GroupDepartment of Anesthesia and Intensive Care Medicine, University of Foggia, Policlinico Riuniti di FoggiaDepartment of Anesthesia, Critical Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico MilanInstiute of Anesthesia and Intensive Care, Padua University HospitalDepartment of Anesthesia, Critical Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico MilanAnesthesia and Intensive Care Unit, Department of Translational Medicine, University of FerraraAnesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University, “Mater Domini” University HospitalDepartment of Surgical, Oncological and Oral Science (Di.Chir.On.S.), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of PalermoDepartment of Anesthesia and Intensive Care Medicine, University of Foggia, Policlinico Riuniti di FoggiaDepartment of Anesthesia, Critical Care and Emergency, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico MilanInstiute of Anesthesia and Intensive Care, Padua University HospitalAbstract Mechanical ventilation is a life-saving technology, but it can also inadvertently induce lung injury and increase morbidity and mortality. Currently, there is no easy method of assessing the impact that ventilator settings have on the degree of lung inssflation. Computed tomography (CT), the gold standard for visually monitoring lung function, can provide detailed regional information of the lung. Unfortunately, it necessitates moving critically ill patients to a special diagnostic room and involves exposure to radiation. A technique introduced in the 1980s, electrical impedance tomography (EIT) can non-invasively provide similar monitoring of lung function. However, while CT provides information on the air content, EIT monitors ventilation-related changes of lung volume and changes of end expiratory lung volume (EELV). Over the past several decades, EIT has moved from the research lab to commercially available devices that are used at the bedside. Being complementary to well-established radiological techniques and conventional pulmonary monitoring, EIT can be used to continuously visualize the lung function at the bedside and to instantly assess the effects of therapeutic maneuvers on regional ventilation distribution. EIT provides a means of visualizing the regional distribution of ventilation and changes of lung volume. This ability is particularly useful when therapy changes are intended to achieve a more homogenous gas distribution in mechanically ventilated patients. Besides the unique information provided by EIT, its convenience and safety contribute to the increasing perception expressed by various authors that EIT has the potential to be used as a valuable tool for optimizing PEEP and other ventilator settings, either in the operative room and in the intensive care unit. The effects of various therapeutic interventions and applications on ventilation distribution have already been assessed with the help of EIT, and this document gives an overview of the literature that has been published in this context.https://doi.org/10.1186/s44158-022-00055-6EITRespiratory monitoringPEEPRecruitment maneuversNon-invasive ventilationNIV |
| spellingShingle | Michela Rauseo Elena Spinelli Nicolò Sella Douglas Slobod Savino Spadaro Federico Longhini Antonino Giarratano Cinnella Gilda Tommaso Mauri Paolo Navalesi SIAARTI Study Group Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond” Journal of Anesthesia, Analgesia and Critical Care EIT Respiratory monitoring PEEP Recruitment maneuvers Non-invasive ventilation NIV |
| title | Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond” |
| title_full | Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond” |
| title_fullStr | Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond” |
| title_full_unstemmed | Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond” |
| title_short | Expert opinion document: “Electrical impedance tomography: applications from the intensive care unit and beyond” |
| title_sort | expert opinion document electrical impedance tomography applications from the intensive care unit and beyond |
| topic | EIT Respiratory monitoring PEEP Recruitment maneuvers Non-invasive ventilation NIV |
| url | https://doi.org/10.1186/s44158-022-00055-6 |
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