Mapping regional differences of local pressure-volume curves with electrical impedance tomography

Página do item simplificado
dc.creatorAlessandro Beda
dc.creatorAlysson Roncally Silva Carvalho
dc.creatorNadja Cristinne Silva Carvalho
dc.creatorSören Hammermüller
dc.creatorMarcelo Britto Passos Amato
dc.creatorThomas Muders
dc.creatorClaudia Gittel
dc.creatorKatharina Noreikat
dc.creatorHermann Wrigge
dc.creatorAndreas Wolfgang Reske
dc.date.accessioned2025-04-03T16:12:00Z
dc.date.accessioned2025-09-08T23:05:57Z
dc.date.available2025-04-03T16:12:00Z
dc.date.issued2017
dc.identifier.doihttps://doi.org/10.1097/ccm.0000000000002233
dc.identifier.issn0090-3493
dc.identifier.urihttps://hdl.handle.net/1843/81274
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofCritical care medicine
dc.rightsAcesso Restrito
dc.subjectTestes de função respiratória DeCS
dc.subjectImpedância (Eletricidade)
dc.subjectRespiracao artificial
dc.titleMapping regional differences of local pressure-volume curves with electrical impedance tomography
dc.typeArtigo de periódico
local.citation.epage686
local.citation.spage679
local.citation.volume45
local.description.resumoObjectives: Lung-protective mechanical ventilation aims to prevent alveolar collapse and overdistension, but reliable bedside methods to quantify them are lacking. We propose a quantitative descriptor of the shape of local pressure-volume curves derived from electrical impedance tomography, for computing maps that highlight the presence and location of regions of presumed tidal recruitment (i.e., elastance decrease during inflation, pressure-volume curve with upward curvature) or overdistension (i.e., elastance increase during inflation, downward curvature). Design: Secondary analysis of experimental cohort study. Setting: University research facility. Subjects: Twelve mechanically ventilated pigs. Interventions: After induction of acute respiratory distress syndrome by hydrochloric acid instillation, animals underwent a decremental positive end-expiratory pressure titration (steps of 2 cm H2O starting from ≥ 26 cm H2O). Measurements and main results: Electrical impedance tomography-derived maps were computed at each positive end-expiratory pressure-titration step, and whole-lung CT taken every second steps. Airway flow and pressure were recorded to compute driving pressure and elastance. Significant correlations between electrical impedance tomography-derived maps and positive end-expiratory pressure indicate that, expectedly, tidal recruitment increases in dependent regions with decreasing positive end-expiratory pressure (p < 0.001) and suggest that overdistension increases both at high and low positive end-expiratory pressures in nondependent regions (p < 0.027), supporting the idea of two different scenarios of overdistension occurrence. Significant correlations with CT measurements were observed: electrical impedance tomography-derived tidal recruitment with poorly aerated regions (r = 0.43; p < 0.001); electrical impedance tomography-derived overdistension with nonaerated regions at lower positive end-expiratory pressures and with hyperaerated regions at higher positive end-expiratory pressures (r ≥ 0.72; p < 0.003). Even for positive end-expiratory pressure levels minimizing global elastance and driving pressure, electrical impedance tomography-derived maps showed nonnegligible regions of presumed overdistension and tidal recruitment. Conclusions: Electrical impedance tomography-derived maps of pressure-volume curve shapes allow to detect regions in which elastance changes during inflation. This could promote individualized mechanical ventilation by minimizing the probability of local tidal recruitment and/or overdistension. Electrical impedance tomography-derived maps might become clinically feasible and relevant, being simpler than currently available alternative approaches.
local.publisher.countryBrasil
local.publisher.departmentENG - DEPARTAMENTO DE ENGENHARIA ELETRÔNICA
local.publisher.initialsUFMG
local.url.externahttps://pubmed.ncbi.nlm.nih.gov/28079607/

Arquivos

Licença do pacote

Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
License.txt
Tamanho:
1.99 KB
Formato:
Plain Text
Descrição:
Baixar

Coleções

Artigo de Periódico

Logo UFMG