Electrical impedance tomography (EIT) for quantification of pulmonary edema in acute lung injury.
- Trepte CJ Department of Anaesthesiology, Center for Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany. c.trepte@uke.de.
- Phillips CR Division of Pulmonary and Critical Care Medicine, Department of Medicine, Center for Intensive Care Research, Oregon Health & Science University, Portland, OR, USA. cphillip3@hotmail.com.
- Solà J CSEM Centre Suisse d'Electronique et de Microtechnique SA, Neuchâtel, Switzerland. josep.solaicaros@csem.ch.
- Adler A Systems and Computer Engineering, Carleton University, Ottawa, ON, Canada. adler@sce.carleton.ca.
- Haas SA Department of Anaesthesiology, Center for Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany. s.haas@uke.de.
- Rapin M CSEM Centre Suisse d'Electronique et de Microtechnique SA, Neuchâtel, Switzerland. michael.rapin@csem.ch.
- Böhm SH Swisstom AG, Landquart, Switzerland. shb@swisstom.com.
- Reuter DA Department of Anaesthesiology, Center for Anaesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany. dreuter@uke.de.
- 2016-01-23
Published in:
- Critical care (London, England). - 2016
Acute Lung Injury
Animals
Disease Models, Animal
Electric Impedance
Extravascular Lung Water
Oleic Acid
Pulmonary Edema
Random Allocation
Sodium Chloride
Swine
Tomography, X-Ray Computed
English
BACKGROUND
Assessment of pulmonary edema is a key factor in monitoring and guidance of therapy in critically ill patients. To date, methods available at the bedside for estimating the physiologic correlate of pulmonary edema, extravascular lung water, often are unreliable or require invasive measurements. The aim of the present study was to develop a novel approach to reliably assess extravascular lung water by making use of the functional imaging capabilities of electrical impedance tomography.
METHODS
Thirty domestic pigs were anesthetized and randomized to three different groups. Group 1 was a sham group with no lung injury. Group 2 had acute lung injury induced by saline lavage. Group 3 had vascular lung injury induced by intravenous injection of oleic acid. A novel, noninvasive technique using changes in thoracic electrical impedance with lateral body rotation was used to measure a new metric, the lung water ratioEIT, which reflects total extravascular lung water. The lung water ratioEIT was compared with postmortem gravimetric lung water analysis and transcardiopulmonary thermodilution measurements.
RESULTS
A significant correlation was found between extravascular lung water as measured by postmortem gravimetric analysis and electrical impedance tomography (r = 0.80; p < 0.05). Significant changes after lung injury were found in groups 2 and 3 in extravascular lung water derived from transcardiopulmonary thermodilution as well as in measurements derived by lung water ratioEIT.
CONCLUSIONS
Extravascular lung water could be determined noninvasively by assessing characteristic changes observed on electrical impedance tomograms during lateral body rotation. The novel lung water ratioEIT holds promise to become a noninvasive bedside measure of pulmonary edema.
Assessment of pulmonary edema is a key factor in monitoring and guidance of therapy in critically ill patients. To date, methods available at the bedside for estimating the physiologic correlate of pulmonary edema, extravascular lung water, often are unreliable or require invasive measurements. The aim of the present study was to develop a novel approach to reliably assess extravascular lung water by making use of the functional imaging capabilities of electrical impedance tomography.
METHODS
Thirty domestic pigs were anesthetized and randomized to three different groups. Group 1 was a sham group with no lung injury. Group 2 had acute lung injury induced by saline lavage. Group 3 had vascular lung injury induced by intravenous injection of oleic acid. A novel, noninvasive technique using changes in thoracic electrical impedance with lateral body rotation was used to measure a new metric, the lung water ratioEIT, which reflects total extravascular lung water. The lung water ratioEIT was compared with postmortem gravimetric lung water analysis and transcardiopulmonary thermodilution measurements.
RESULTS
A significant correlation was found between extravascular lung water as measured by postmortem gravimetric analysis and electrical impedance tomography (r = 0.80; p < 0.05). Significant changes after lung injury were found in groups 2 and 3 in extravascular lung water derived from transcardiopulmonary thermodilution as well as in measurements derived by lung water ratioEIT.
CONCLUSIONS
Extravascular lung water could be determined noninvasively by assessing characteristic changes observed on electrical impedance tomograms during lateral body rotation. The novel lung water ratioEIT holds promise to become a noninvasive bedside measure of pulmonary edema.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s13054-015-1173-5
- PMID 26796635
- Persistent URL
- https://sonar.ch/global/documents/58326
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