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ELECTRICAL IMPEDANCE TOMOGRAPHY – CASE REPORT WITH SHORT REVIEW OF TECHNOLOGY AND CLINICAL APPLICATION SCENARIOS
ANDREJ ŠRIBAR
orcid.org/0000-0002-6517-9895
; Sveučilište u Zagrebu, Stomatološki fakultet, Klinička bolnica Dubrava, Klinika za anesteziologiju, reanimatologiju i intenzivnu medicinu, Zagreb, Hrvatska
JASMINKA PERŠEC
orcid.org/0000-0002-3777-8153
; Sveučilište u Zagrebu, Stomatološki fakultet, Klinička bolnica Dubrava, Klinika za anesteziologiju, reanimatologiju i intenzivnu medicinu, Zagreb, Hrvatska
DANICA BOŠNJAK
; Sveučilište u Zagrebu, Stomatološki fakultet, Klinička bolnica Dubrava, Klinika za anesteziologiju, reanimatologiju i intenzivnu medicinu, Zagreb, Hrvatska
LJILJANA VUKOVIĆ
orcid.org/0000-0001-5893-4242
; Sveučilište u Zagrebu, Stomatološki fakultet, Klinička bolnica Dubrava, Klinika za anesteziologiju, reanimatologiju i intenzivnu medicinu, Zagreb, Hrvatska
NIKOLA BRADIĆ
; Sveučilište u Zagrebu, Stomatološki fakultet, Klinička bolnica Dubrava, Klinika za anesteziologiju, reanimatologiju i intenzivnu medicinu, Zagreb, Hrvatska
VLASTA KLARIĆ
orcid.org/0000-0002-0105-6108
; Sveučilište u Zagrebu, Stomatološki fakultet, Klinička bolnica Dubrava, Klinika za anesteziologiju, reanimatologiju i intenzivnu medicinu, Zagreb, Hrvatska
Sažetak
Electrical impedance tomography (EIT) is a noninvasive monitoring method which is primarily used to assess regional distribution of ventilation in the lungs, but other uses (such as perfusion mapping) have been documented as well. It works on the physical principle of varying impedance of various tissues or differences in aeration of lung tissue. A tomogram is then dynamically generated by computer software to show regional distribution of ventilation. Clinically agreeable correlation was found between EIT and computed tomography (CT) assessment of recruitable alveolar collapse, which makes EIT a valuable bedside diagnostic tool to aid recruitment maneuvers in patients with acute respiratory distress syndrome (ARDS). We present a patient with ARDS induced by intraoperative aspiration of gastric contents, who was admitted to the intensive care unit (ICU). After initiation of mechanical ventilation and bronchoscopy guided alveolar lavage, stepwise positive end expiratory pressure (PEEP) trial was performed using EIT to detect alveolar overdistension or collapse. PEEP value of 14 mbar was established as the lowest level of PEEP above alveolar collapse. Arterial blood gas tests after the trial showed marked improvement over baseline values, the patient was extubated on the next day, discharged from the ICU two days later, and discharged from the hospital 4 days later without any respiratory complications.
Ključne riječi
electrical impedance tomography; acute respiratory distress syndrome; computed tomography; mechanical ventilation; positive end expiratory pressure
Hrčak ID:
197904
URI
Datum izdavanja:
3.4.2018.
Posjeta: 1.223 *