Becher, T. H., Miedema, M., Kallio, M., Papadouri, T., Karaoli, C., Sophocleous, L., Rahtu, M., Van Leuteren, R. W., Waldmann, A. D., Strodthoff, C., Yerworth, R., Dupré, A., Benissa, M.-R., Nordebo, S., Khodadad, D., Bayford, R., Vliegenthart, R., Rimensberger, P. C., Van Kaam, A. H., & Frerichs, I. (2022). Prolonged continuous monitoring of regional lung function in infants with respiratory failure. Annals of the American Thoracic Society, 19(6), 991–999. https://doi.org/10.1513/AnnalsATS.202005-562OC
Prolonged continuous monitoring of regional lung function in infants with respiratory failure
|Author:||Becher, Tobias H.1; Miedema, Martijn2; Kallio, Merja3;|
1Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig- Holstein, Campus Kiel, Germany
2Department of Neonatology, Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
3PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu, and Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
4Department of Neonatology, Archbishop Makarios III Hospital, Nicosia, Cyprus
5Department of Electrical and Computer Engineering, University of Cyprus, Nicosia, Cyprus
6SenTec AG (formerly Swisstom AG), Landquart, Switzerland
7Department of Anesthesiology and Intensive Care Medicine, Rostock University Medical Center, Rostock, Germany
8Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom
9Division of Neonatology and Paediatric Intensive Care, Department of Paediatrics, University Hospital of Geneva, University of Geneva, Switzerland
10Department of Physics and Electrical Engineering, Linnaeus University, Växjö, Sweden
11Department of Natural Sciences, Middlesex University, London, United Kingdom
|Online Access:||PDF Full Text (PDF, 1.3 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2023030329580
American Thoracic Society,
|Publish Date:|| 2023-06-01
Rationale: Electrical impedance tomography (EIT) allows instantaneous and continuous visualization of regional ventilation and changes in end-expiratory lung volume at the bedside. There is particular interest in using EIT for monitoring in critically ill neonates and young children with respiratory failure. Previous studies have focused only on short-term monitoring in small populations. The feasibility and safety of prolonged monitoring with EIT in neonates and young children has not been demonstrated yet.
Objectives: To evaluate the feasibility and safety of long-term EIT monitoring in a routine clinical setting and to describe changes in ventilation distribution and homogeneity over time and with positioning in a multi-center cohort of neonates and young children with respiratory failure.
Methods: At four European University Hospitals, we conducted an observational study (NCT02962505) on 200 patients with post-menstrual ages (PMA) between 25 weeks and 36 months, at risk for or suffering from respiratory failure. Continuous EIT data were obtained using a novel textile 32-electrode interface and recorded at 48 images/s for up to 72 hours. Clinicians were blinded to EIT images during the recording. EIT parameters and the effects of body position on ventilation distribution were analyzed offline.
Results: The average duration of EIT measurements was 53 ± 20 hours. Skin contact impedance was sufficient to allow image reconstruction for valid ventilation analysis during a median of 92% (interquartile range, 77–98%) of examination time. EIT examinations were well tolerated, with minor skin irritations (temporary redness or imprint) occurring in 10% of patients and no moderate or severe adverse events. Higher ventilation amplitude was found in the dorsal and right lung areas when compared with the ventral and left regions, respectively. Prone positioning resulted in an increase in the ventilation-related EIT signal in the dorsal hemithorax, indicating increased ventilation of the dorsal lung areas. Lateral positioning led to a redistribution of ventilation toward the dependent lung in preterm infants and to the nondependent lung in patients with PMA > 37 weeks.
Conclusions: EIT allows continuous long-term monitoring of regional lung function in neonates and young children for up to 72 hours with minimal adverse effects. Our study confirmed the presence of posture-dependent changes in ventilation distribution and their dependency on PMA in a large patient cohort.
Annals of the American Thoracic Society
|Pages:||991 - 999|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3123 Gynaecology and paediatrics
3126 Surgery, anesthesiology, intensive care, radiology
Supported by the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement 668259 and by the Swiss State Secretariat for Education, Research and Innovation (SERI) under contract number 15.0342-1. M.K. was funded by the Finnish Foundation for Pediatric Research.
Originally Published in: Becher, T. H., Miedema, M., Kallio, M., Papadouri, T., Karaoli, C., Sophocleous, L., Rahtu, M., Van Leuteren, R. W., Waldmann, A. D., Strodthoff, C., Yerworth, R., Dupré, A., Benissa, M.-R., Nordebo, S., Khodadad, D., Bayford, R., Vliegenthart, R., Rimensberger, P. C., Van Kaam, A. H., & Frerichs, I. Prolonged continuous monitoring of regional lung function in infants with respiratory failure. Annals of the American Thoracic Society 2022;19(6):991–999. DOI:10.1513/AnnalsATS.202005-562OC. Copyright © 2022 by the American Thoracic Society. The final publication is available at https://doi.org/10.1513/AnnalsATS.202005-562OC.