Ultrasound detection of diaphragm position in the region for lung monitoring by electrical impedance tomography during laparoscopy

Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Kristyna BuzkovaTomas Tyll

Abstract

During laparoscopic surgery, a capnoperitoneum is created to optimize the operating space for surgeons. One effect of this is abdominal pressure which alters the physiological thoraco-abdominal configuration and pushes the diaphragm and lungs cranially. Since the lung image acquired by electrical impedance tomography (EIT) depends on the conditions within the thorax and abdomen, it is crucial to know the diaphragm position to determine the effect of diaphragm shift on EIT thorax image. The presence of diaphragm in the region of EIT measurement was determined by ultrasound in 20 patients undergoing laparoscopic surgery. Data were obtained in the supine position during spontaneous breathing in a mechanically ventilated patient under general anesthesia with muscle relaxation and in a mechanically ventilated patient under general anesthesia with muscle relaxation during capnoperitoneum. The diaphragm was shifted cranially during capnoperitoneum. The diaphragm detection rate rose by 10% during capnoperitoneum at the fifth intercostal space, from 55% to 65% and by 10% from 0% at mid-sternal level compared to mechanical ventilation without capnoperitoneum. The diaphragm was detected in the area contributing to the creation of the thor...Continue Reading

References

Jul 9, 2010·Best Practice & Research. Clinical Anaesthesiology·Franco ValenzaLuciano Gattinoni
Jan 9, 2016·Critical Care : the Official Journal of the Critical Care Forum·Jan KarstenHermann Heinze

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