67
views
0
recommends
+1 Recommend
0 collections
    4
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group

      research-article
      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ,   12 , 2 , 13 , 14 , 15 , 16 , 17 , 8 , TREND study group
      (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab)
      Thorax
      BMJ Publishing Group
      ARDS, Paediatric Lung Disaese, Assisted Ventilation, Imaging/CT MRI etc

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Electrical impedance tomography (EIT) has undergone 30 years of development. Functional chest examinations with this technology are considered clinically relevant, especially for monitoring regional lung ventilation in mechanically ventilated patients and for regional pulmonary function testing in patients with chronic lung diseases. As EIT becomes an established medical technology, it requires consensus examination, nomenclature, data analysis and interpretation schemes. Such consensus is needed to compare, understand and reproduce study findings from and among different research groups, to enable large clinical trials and, ultimately, routine clinical use. Recommendations of how EIT findings can be applied to generate diagnoses and impact clinical decision-making and therapy planning are required. This consensus paper was prepared by an international working group, collaborating on the clinical promotion of EIT called TRanslational EIT developmeNt stuDy group. It addresses the stated needs by providing (1) a new classification of core processes involved in chest EIT examinations and data analysis, (2) focus on clinical applications with structured reviews and outlooks (separately for adult and neonatal/paediatric patients), (3) a structured framework to categorise and understand the relationships among analysis approaches and their clinical roles, (4) consensus, unified terminology with clinical user-friendly definitions and explanations, (5) a review of all major work in thoracic EIT and (6) recommendations for future development (193 pages of online supplements systematically linked with the chief sections of the main document). We expect this information to be useful for clinicians and researchers working with EIT, as well as for industry producers of this technology.

          Related collections

          Most cited references85

          • Record: found
          • Abstract: found
          • Article: not found

          Imbalances in regional lung ventilation: a validation study on electrical impedance tomography.

          Imbalances in regional lung ventilation, with gravity-dependent collapse and overdistention of nondependent zones, are likely associated to ventilator-induced lung injury. Electric impedance tomography is a new imaging technique that is potentially capable of monitoring those imbalances. The aim of this study was to validate electrical impedance tomography measurements of ventilation distribution, by comparison with dynamic computerized tomography in a heterogeneous population of critically ill patients under mechanical ventilation. Multiple scans with both devices were collected during slow-inflation breaths. Six repeated breaths were monitored by impedance tomography, showing acceptable reproducibility. We observed acceptable agreement between both technologies in detecting right-left ventilation imbalances (bias = 0% and limits of agreement = -10 to +10%). Relative distribution of ventilation into regions or layers representing one-fourth of the thoracic section could also be assessed with good precision. Depending on electrode positioning, impedance tomography slightly overestimated ventilation imbalances along gravitational axis. Ventilation was gravitationally dependent in all patients, with some transient blockages in dependent regions synchronously detected by both scanning techniques. Among variables derived from computerized tomography, changes in absolute air content best explained the integral of impedance changes inside regions of interest (r(2) > or = 0.92). Impedance tomography can reliably assess ventilation distribution during mechanical ventilation.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Evaluation of an electrical impedance tomography-based Global Inhomogeneity Index for pulmonary ventilation distribution.

            To evaluate the plausibility, stability, and interindividual comparability of the global inhomogeneity index (GI) based on electrical impedance tomography (EIT). The lung area in an EIT image was identified by using the lung area estimation method, which mirrors the lung regions in the functional EIT image and subsequently subtracts the cardiac-related areas. The tidal EIT image, showing the difference in impedances between end-inspiration and end-expiration, was calculated and the variations in its pixel values within the predefined lung area were then used as an indicator of inhomogeneous ventilation (the GI index). Fifty patients were investigated including 40 patients tracheally intubated with double-lumen tubes (test group) and 10 patients under anesthesia without pulmonary disease (control group). Positive end-expiratory pressure (PEEP) of 5 mbar was applied in the test group during both two-lung ventilation (TLV) and subsequent one-lung ventilation (OLV). The patients of the control group were ventilated without PEEP. EIT data were recorded in both groups. A significantly lower GI value was found in the control group (0.40 +/- 0.05, P = 0.025 vs. TLV 0.74 +/- 0.47 and P < 0.002 vs. OLV 1.51 +/- 1.45). A significant difference was also found in the test group between TLV and OLV (P < 0.002). If GI was calculated only in the ventilated lung area during OLV (0.71 +/- 0.32), it did not significantly differ from the test group during TLV. The GI index quantifies the gas distribution in the lung with a single number and reveals good interpatient comparability.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Detection of local lung air content by electrical impedance tomography compared with electron beam CT.

              The aim of the study was to validate the ability of electrical impedance tomography (EIT) to detect local changes in air content, resulting from modified ventilator settings, by comparing EIT findings with electron beam computed tomography (EBCT) scans obtained under identical steady-state conditions. The experiments were carried out on six anesthetized supine pigs ventilated with five tidal volumes (VT) at three positive end-expiratory pressure (PEEP) levels. The lung air content changes were determined both by EIT (Goe-MF1 system) and EBCT (Imatron C-150XP scanner) in six regions of interest, located in the ventral, middle, and dorsal areas of each lung, with respect to the reference air content at the lowest VT and PEEP, as a change in either local electrical impedance or lung tissue density. An increase in local air content with VT and PEEP was identified by both methods at all regions studied. A good correlation between the changes in lung air content determined by EIT and EBCT was revealed. Mean correlation coefficients in the ventral, middle, and dorsal regions were 0.81, 0.87, and 0.93, respectively. The study confirms that EIT is a suitable, noninvasive method for detecting regional changes in air content and monitoring local effects of artificial ventilation.
                Bookmark

                Author and article information

                Journal
                Thorax
                Thorax
                thoraxjnl
                thorax
                Thorax
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0040-6376
                1468-3296
                January 2017
                05 September 2016
                : 72
                : 1
                : 83-93
                Affiliations
                [1 ]Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel , Kiel, Germany
                [2 ]Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo, Brazil
                [3 ]Department of Neonatology, Emma Children's Hospital, Academic Medical Center , Amsterdam, The Netherlands
                [4 ]Neonatal Research, Murdoch Childrens Research Institute , Parkville, Victoria, Australia
                [5 ]Institute of Technical Medicine, Furtwangen University , Villingen-Schwenningen, Germany
                [6 ]Fraunhofer Project Group for Automation in Medicine and Biotechnology PAMB, Mannheim, Germany
                [7 ]Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University , Mainz, Germany
                [8 ]Department of Systems and Computer Engineering, Carleton University , Ottawa, Ontario, Canada
                [9 ]Swisstom AG , Landquart, Switzerland
                [10 ]Dräger Medical GmbH , Lübeck, Germany
                [11 ]Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital , Gothenburg, Sweden
                [12 ]Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
                [13 ]Department of Adult Critical Care, Guy's and St Thomas’ NHS Foundation Trust , London, UK
                [14 ]Paediatric Critical Care Research Group, Mater Research University of Queensland , South Brisbane, Australia
                [15 ]Children's Hospital Traunstein, Ludwig Maximilian's University , Munich, Germany
                [16 ]Department of Adult Intensive Care, Erasmus MC , Rotterdam, The Netherlands
                [17 ]Philips Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University , Aachen, Germany
                Author notes
                [Correspondence to ] Professor Dr Inéz Frerichs, Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Kiel 24105, Germany; frerichs@ 123456anaesthesie.uni-kiel.de
                Article
                thoraxjnl-2016-208357
                10.1136/thoraxjnl-2016-208357
                5329047
                27596161
                95bd3517-6918-495e-9e6a-aac887a2df8e
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 19 January 2016
                : 12 July 2016
                : 16 July 2016
                Categories
                1506
                State of the Art Review
                Custom metadata
                unlocked

                Surgery
                ards,paediatric lung disaese,assisted ventilation,imaging/ct mri etc
                Surgery
                ards, paediatric lung disaese, assisted ventilation, imaging/ct mri etc

                Comments

                Comment on this article