Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography

Nenhuma Miniatura disponível
Citações na Scopus
7
Tipo de produção
bookPart
Data de publicação
2012
DOI
Scopus
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER BERLIN HEIDELBERG
Autores
MELO, A.
SUAREZ-SIPMANN, F.
BOHM, S. H.
Citação
Costa, E. L. V.; Borges, J. B.; Melo, A.; Suarez-Sipmann, F.; Toufen, C. Jr.; Bohm, S. H.; Amato, M. B. P.. Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. In: . APPLIED PHYSIOLOGY IN INTENSIVE CARE MEDICINE 1: PHYSIOLOGICAL NOTES - TECHNICAL NOTES - SEMINAL STUDIES IN INTENSIVE CARE, THIRD EDITION: SPRINGER BERLIN HEIDELBERG, 2012. p.165-170.
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: To present a novel algorithm for estimating recruitable alveolar collapse and hyperdistension based on electrical impedance tomography (EIT) during a decremental positive end-expiratory pressure (PEEP) titration. Design: Technical note with illustrative case reports. Setting: Respiratory intensive care unit. Patient: Patients with acute respiratory distress syndrome. Interventions: Lung recruitment and PEEP titration maneuver. Measurements and results: Simultaneous acquisition of EIT and X-ray computerized tomography (CT) data. We found good agreement (in terms of amount and spatial location) between the collapse estimated by EIT and CT for all levels of PEEP. The optimal PEEP values detected by EIT for patients 1 and 2 (keeping lung collapse \10%) were 19 and 17 cmH2O, respectively. Although pointing to the same non1dependent lung regions, EIT estimates of hyperdistension represent the functional deterioration of lung units, instead of their anatomical changes, and could not be compared directly with static CT estimates for hyperinflation. Conclusions: We described an EIT-based method for estimating recruitable alveolar collapse at the bedside, pointing out its regional distribution. Additionally, we proposed a measure of lung hyperdistension based on regional lung mechanics. © Springer-Verlag Berlin Heidelberg 2006, 2009, 2012.
Palavras-chave
Acute lung injury, Acute respiratory distress syndrome, Computed tomography, Electrical impedance tomography, Lung recruitment, Mechanical ventilation, Positive end-expiratory pressure
URI
https://observatorio.fm.usp.br/handle/OPI/51312
Referências
  1. Tremblay, L.N., Slutsky, A.S., Ventilator-induced injury: From barotrauma to biotrauma (1998) Proc Assoc am Physicians, 110, pp. 482-488
  2. Plotz, F.B., Slutsky, A.S., Van Vught, A.J., Heijnen, C.J., Ventilator-induced lung injury and multiple system organ failure: A critical review of facts and hypotheses (2004) Intensive Care Med, 30, pp. 1865-1872
  3. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The acute respiratory distress syndrome network (2000) N Engl J Med, 342, pp. 1301-1308
  4. Amato, M., Barbas, C.S., Medeiros, D.M., Magaldi, R.B., Schettino, G.P., Lorenzi-Filho, G., Kairalla, R.A., Carvalho, C.R., Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome (1998) N Engl J Med, 338, pp. 347-354
  5. Villar, J., Kacmarek, R.M., Perez-Mendez, L., Aguirre-Jaime, A., A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: A randomized, controlled trial (2006) Crit Care Med, 34, pp. 1311-1318
  6. Ranieri, V.M., Suter, P.M., Tortorella, C., De Tullio, R., Dayer, J.M., Brienza, A., Bruno, F., Slutsky, A.S., Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: A randomized controlled trial (1999) JAMA, 282, pp. 54-61
  7. Suarez-Sipmann, F., Bohm, S.H., Tusman, G., Pesch, T., Thamm, O., Reissmann, H., Reske, A., Hedenstierna, G., Use of dynamic compliance for open lung positive end-expiratory pressure titration in an experimental study (2007) Crit Care Med, 35, pp. 214-221
  8. Borges, J.B., Carvalho, C., Amato, M., Lung recruitment in patients with ards (2006) N Engl J Med, 355, pp. 319-320. , (author reply 321-322)
  9. Borges, J.B., Vn, O., Matos, G., Caramez, M., Arantes, P.R., Barros, F., Souza, C.E., Amato, M., Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome (2006) Am J Respir Crit Care Med, 174, pp. 268-278
  10. Terragni, P.P., Rosboch, G., Tealdi, A., Corno, E., Menaldo, E., Davini, O., Gandini, G., Ranieri, V.M., Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome (2007) Am J Respir Crit Care Med, 175, pp. 160-166
  11. Grasso, S., Stripoli, T., De Michele, M., Bruno, F., Moschetta, M., Angelelli, G., Munno, I., Fiore, T., Ardsnet ventilatory protocol and alveolar hyperinflation: Role of positive end-expiratory pressure (2007) Am J Respir Crit Care Med, 176, pp. 761-767
  12. Victorino, J.A., Borges, J.B., Okamoto, V.N., Matos, G., Tucci, M.R., Caramez, M., Tanaka, H., Amato, M., Imbalances in regional lung ventilation: A validation study on electrical impedance tomography (2004) Am J Respir Crit Care Med, 169, pp. 791-800
  13. Frerichs, I., Hinz, J., Herrmann, P., Weisser, G., Hahn, G., Dudykevych, T., Quintel, M., Hellige, G., Detection of local lung air content by electrical impedance tomography compared with electron beam ct (2002) J Appl Physiol, 93, pp. 660-666
  14. Frerichs, I., Hahn, G., Schiffmann, H., Berger, C., Hellige, G., Monitoring regional lung ventilation by functional electrical impedance tomography during assisted ventilation (1999) Ann NY Acad Sci, 873, pp. 493-505
  15. Adler, A., Amyot, R., Guardo, R., Bates, J.H., Berthiaume, Y., Monitoring changes in lung air and liquid volumes with electrical impedance tomography (1997) J Appl Physiol, 83, pp. 1762-1767
  16. Hickling, K.G., Best compliance during a decremental, but not incremental, positive end-expiratory pressure trial is related to open-lung positive end-expiratory pressure: A mathematical model of acute respiratory distress syndrome lungs (2001) Am J Respir Crit Care Med, 163, pp. 69-78
  17. Frazer, D.G., Weber, K.C., Franz, G.N., Evidence of sequential opening and closing of lung units during inflation-deflation of excised rat lungs (1985) Respir Physiol, 61, pp. 277-288
  18. Bersten, A.D., Measurement of overinflation by multiple linear regression analysis in patients with acute lung injury (1998) Eur Respir J, 12, pp. 526-532
  19. Hedenstierna, G., Tokics, L., Strandberg, A., Lundquist, H., Brismar, B., Correlation of gas exchange impairment to development of atelectasis during anaesthesia and muscle paralysis (1986) Acta Anaesthesiol Scand, 30, pp. 183-191
  20. Frerichs, I., Hahn, G., Hellige, G., Gravity-dependent phenomena in lung ventilation determined by functional eit (1996) Physiol Meas, 17, pp. A149-A157
  21. Simon, B.A., Christensen, G.E., Low, D.A., Reinhardt, J.M., Computed tomography studies of lung mechanics (2005) Proc am Thorac Soc, 2, pp. 506-507. , (517-521)
  22. Gattinoni, L., Pelosi, P., Vitale, G., Pesenti, A., D’ Andrea, L., Mascheroni, D., Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure (1991) Anesthesiology, 74, pp. 15-23
  23. Frerichs, I., Dargaville, P.A., Dudykevych, T., Rimensberger, P.C., Electrical impedance tomography: A method for monitoring regional lung aeration and tidal volume distribution? (2003) Intensive Care Med, 29, pp. 2312-2316
  24. Meier, T., Luepschen, H., Karsten, J., Leibecke, T., Großherr, M., Gehring, H., Leonhardt, S., Assessment of regional lung recruitment and derecruitment during a peep trial based on electrical impedance tomography (2008) Intensive Care Med, 34, pp. 543-550
  25. Lindgren, S., Odenstedt, H., Olegärd, C., Sondergaard, S., Lundin, S., Stenqvist, O., Regional lung derecruitment after endotracheal suction during volume- or pressure-controlled ventilation: A study using electric impedance tomography (2007) Intensive Care Med, 33, pp. 172-180
  26. Erlandsson, K., Odenstedt, H., Lundin, S., Stenqvist, O., Positive end-expiratory pressure optimization using electric impedance tomography in morbidly obese patients during laparoscopic gastric bypass surgery (2006) Acta Anaesthesiol Scand, 50, pp. 833-839
  27. Hinz, J., Gehoff, A., Moerer, O., Frerichs, I., Hahn, G., Hellige, G., Quintel, M., Regional filling characteristics of the lungs in mechanically ventilated patients with acute lung injury (2007) Eur J Anaesthesiol, 24, pp. 414-424

Coleções
Livros e Capítulos de Livros - HC/InCor
Livros e Capítulos de Livros - HC/ICHC
Livros e Capítulos de Livros - LIM/09