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Electrical impedance tomography at two thoracic levels provides detailed information about ventilation distribution in the cranial to caudal direction

Introduction

Electrical impedance tomography (EIT) is a promising new tool for bedside monitoring of regional lung ventilation. Several studies have focused on the ventilation distribution and relationship with regional lung volume on a lower, caudal lung level. However, no information is available at a higher, cranial lung level.

Methods

EIT (EIT Evaluation Kit 2; Dräger, Lübeck, Germany) was measured at cranial and caudal lung levels in 10 patients after cardiothoracic surgery. Patients were fully sedated and mechanically ventilated and a PEEP trial was performed at four PEEP levels (15, 10, 5 and 0 cmH2O).

Results

The center of gravity index decreased after lowering the PEEP level at both the caudal and cranial lung levels (Figure 1 right). Whereas the tidal volume impedance variation divided by tidal volume increased at the cranial lung level and decreased at the caudal lung level during the step-wise reductions in PEEP (Figure 1 left).

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Figure 1

Conclusions

During decremental PEEP steps, the ventilation distribution not only shifts from a dorsal to ventral direction, but also from the caudal to cranial direction.

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Correspondence to I Bikker.

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Bikker, I., Preis, C., Bakker, J. et al. Electrical impedance tomography at two thoracic levels provides detailed information about ventilation distribution in the cranial to caudal direction. Crit Care 14, P173 (2010). https://doi.org/10.1186/cc8405

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Keywords

  • Tidal Volume
  • Electrical Impedance Tomography
  • Regional Lung
  • Lung Ventilation
  • Peep Level