Comparison of methods to quantify lung overdistension and tidal recruitment based on EIT
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Universidade Federal de Minas Gerais
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Membros da banca
Resumo
Protective ventilation strategies have been
proposed to minimize the occurrence of lung
overdistension (OD), as well as the presence of tidal
recruitment (TR) of airways and alveolar units. In this
context, Electrical Impedance Tomography (EIT)
emerges as a noninvasive, radiation-free imaging
technique, for bedside monitoring the regional
distribution of ventilation in the lungs. Different EIT
methods exist to quantify OD and TR: 1) PVShape
quantifies the curvature of the pressure-volume curve
during inspiration (PVShapeinsp) and expiration
(PVShapeexp); 2) the algorithm RACH is based on the
estimation of the compliance changes in each element
through the PEEP steps. Thus, the objective of this study
is to compare these published algorithms to quantify
changes in spatial distribution of OD and TR during
mechanical ventilation. EIT was collected from 19
mechanically ventilated surgical patients during a
decremental positive end-expiratory pressure (PEEP)
titration maneuver. The proportion of TR and OD at each
PEEP step was computed from EIT according with each
algorithm. The spatial distribution of OD and TR was
significantly affected by PEEP changes. Compared to the
other methods, the estimates of TR were considerably
higher with PVShapeinsp (more than 60% larger, p<0.001).
While the higher significant proportion of OD was found
in the PVShapeexp (more than 6% larger, p<0.001). This
study demonstrates a significant disagreement between
TR and OD quantified by these three EIT-based methods.
Despite the statistic difference between RACH and
PVShapeexp, these methods present information that
appears to be reasonably compatible.
Abstract
Assunto
Respiração Artificial DeCS, Ventilação não Invasiva DeCS, Impedância (Eletricidade)
Palavras-chave
Electric impedance tomography, Mechanical ventilation, Overdistension, Tidal recruitment, improper MV settings may lead to alveolar overdistension (OD) and tidal recruitment (TR), which increase the risk of ventilator-induced lung injury
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https://www.even3.com.br/anais/xiseb/128302