Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Bedside measurement of changes in lung impedance to monitor alveolar ventilation in dependent and non-dependent parts by electrical impedance tomography during a positive end-expiratory pressure trial in mechanically ventilated intensive care unit patients. | Bikker et al. Critical Care 2010 14 R100 http content 14 3 R100 c CRITICAL CARE RESEARCH Open Access Bedside measurement of changes in lung impedance to monitor alveolar ventilation in dependent and non-dependent parts by electrical impedance tomography during a positive end-expiratory pressure trial in mechanically ventilated intensive care unit patients 1 2 11 1 Ido G Bikker Steffen Leonhardt Dinis Reis Miranda Jan Bakker Diederik Gommers Abstract Introduction As it becomes clear that mechanical ventilation can exaggerate lung injury individual titration of ventilator settings is of special interest. Electrical impedance tomography EIT has been proposed as a bedside regional monitoring tool to guide these settings. In the present study we evaluate the use of ventilation distribution change maps AfEIT maps in intensive care unit ICU patients with or without lung disorders during a standardized decremental positive end-expiratory pressure PEEP trial. Methods Functional EIT fEIT images and PaO2 FiO2 ratios were obtained at four PEEP levels 15 to 10 to 5 to 0 cm H2O in 14 ICU patients with or without lung disorders. Patients were pressure-controlled ventilated with constant driving pressure. fEIT images made before each reduction in PEEP were subtracted from those recorded after each PEEP step to evaluate regional increase decrease in tidal impedance in each EIT pixel AfEIT maps . Results The response of regional tidal impedance to PEEP showed a significant difference from 15 to 10 P and from 10 to 5 P between patients with and without lung disorders. Tidal impedance increased only in the non-dependent parts in patients without lung disorders after decreasing PEEP from 15 to 10 cm H2O whereas it decreased at the other PEEP steps in both groups. Conclusions During a decremental PEEP trial in ICU patients EIT measurements performed just above the diaphragm clearly visualize improvement and loss of ventilation in dependent and non-dependent parts
