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

Journal of Clinical Monitoring and Computing
Serge J H HeinesDennis C J J Bergmans

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 4 cm H2O as clinically relevant. Changes in lung compliance and PaO2/FiO2-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/FiO2-ratio. However, this increase was also observed in the group where the PEEP difference was less than 4 cm 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.

References

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Citations

Oct 7, 2019·Journal of Clinical Monitoring and Computing·Zhanqi ZhaoKnut Möller
May 6, 2020·Journal of Medical Virology·Jialin Liu, Siru Liu
Aug 12, 2020·Journal of Clinical Monitoring and Computing·Yi ChiYun Long
Feb 17, 2019·Intensive Care Medicine Experimental·Inéz FrerichsPeter C Rimensberger
Apr 5, 2019·Minerva anestesiologica·Francesco VasquesLuigi Camporota
Jan 26, 2020·Journal of Clinical Monitoring and Computing·D S KarbingM B Jaffe
Mar 14, 2020·Critical Care Explorations·Isabel RosemeierGerhard K Wolf

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Software Mentioned

MATLAB
EIT
EITdiag
SPSS

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