Electrical impedance tomography: A method for monitoring regional lung aeration and tidal volume distribution?

Abstract

Objective: To demonstrate the monitoring capacity of modern electrical impedance tomography (EIT) as an indicator of regional lung aeration and tidal volume dis-tribution. Design and setting: Short-term ventilation experiment in an animal research laboratory. Patients and participants: One newborn piglet (body weight: 2 kg). Interventions: Surfactant depletion by repeated bronchoalveolar lavage, surfactant administration. Measurements and results: EIT scanning was performed at an acquisition rate of 13 images/s during two ventilatory manoeuvres performed before and after surfactant administration. During the scanning periods of 120 s the piglet was ventilated with a tidal volume of 10 ml/kg at positive end-expiratory pressures (PEEP) in the range of 0-30 cmH2O, increasing and decreasing in 5 cmH2O steps. Local changes in aeration and ventilation with PEEP were visualised by EIT scans showing the regional shifts in end-expiratory lung volume and distribution of tidal volume, respectively. In selected regions of interest EIT clearly identified the changes in local aeration and tidal volume distribution over time and after surfactant treatment as well as the differences between stepwise inflation and deflation. Conclusions: Our data indicate that modern EIT devices provide an assessment of regional lung aeration and tidal volume and allow evaluation of immediate effects of a change in ventilation or other therapeutic intervention. Future use of EIT in a clinical setting is expected to optimise the selection of appropriate ventilation strategies.