Abstract
EIT is a radiation-free functional modality that enables bedside imaging and monitoring of lung function and expansion. Clinical interest in this method has been driven by the need for bedside monitoring of the dynamics of the lungs and the effects of ventilatory manoeuvres, including changes in ventilator settings, suctioning, chest drains, positioning and physiotherapy. We aimed to describe the use of Electrical Impedance Tomography (EIT) as a clinical tool in a tertiary Paediatric Intensive Care unit. Children requiring intensive care with a variety of clinical conditions had an electrode belt with 16 electrodes wrapped around the chest, which sequentially applied a small alternating current from each electrode pair. The signal gives information on both real time, regional, global, and relative data. With the correct application, and understanding of the monitor, much clinical information can be gained, with potentially significant patient benefit. We present the clinical use of EIT in six conditions: Asthma, Ventilation weaning and expansion recoil, Sequential Lobar Collapse, Targeted Physiotherapy, Pleural Effusion assessment, and PEEP optimisation. Screenshots and analyses are offered displaying the pragmatic use of this technology. Electrical Impedance Tomography is a clinically useful tool on the Paediatric Intensive Care unit. It allows monitoring of a patient’s respiratory function in ways which are not possible through any other means. An understanding of respiratory physiology will allow use of this information to improve patient outcomes.
Highlights
Electrical Impedance Tomography (EIT) is a radiation-free functional modality that enables bedside imaging and monitoring of lung function and expansion
EIT does not offer the same spatial resolution when compared with modalities such as Computerised Tomography (CT) scanning
The images produced can be affected by body movement, changes in electrode contact, changes in posture[21], as well as interference with other medical devices[22]. These need to be considered when interpreting the images. Clinical interest in this method has been driven by the need for bedside monitoring of the dynamics of the lungs and the effects of ventilatory manoeuvres, including changes in ventilator settings, suctioning, chest drains, positioning and physiotherapy
Summary
Electrical Impedance Tomography (EIT) is a radiation-free functional modality that enables bedside imaging and monitoring of lung function and expansion. It has been evaluated in a number of pulmonary conditions in humans and animal models[1,2,3,4,5,6,7,8]. The images produced can be affected by body movement, changes in electrode contact, changes in posture[21], as well as interference with other medical devices[22] These need to be considered when interpreting the images. Our aim is to disseminate our experience of the use of Electrical Impedance Tomography in the use of patients in Paediatric Intensive Care, to act as a clinical primer for other clinicians and to communicate the pragmatic use of this technology
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