Paper Info
Title
Monitoring of cardiac output and lung ventilation by Electrical Impedance Tomography in a porcine model of acute lung injury
Abstract
Adequate medical treatment of the Acute Respiratory Distress Syndrome is still challenging since patient-individual aspects have to be taken into account. Lung protective ventilation and hemodynamic stability have always been two of the most crucial aims of intensive care therapy. For both aspects, a continuous - preferably non-invasive - monitoring is desirable that is available at the bedside. Unfortunately, there is no technique clinically established yet, that provides both measurement of cardiac stroke volume and ventilation dynamics in real-time. Electrical Impedance Tomography (EIT) is a promising technique to close this gap. The aim of the study was to investigate if stroke volume can be estimated by a self-developed software using EIT-based image analysis. In addition, two EIT-derived parameters, namely Global Inhomogeneity Index (GII) and Impedance Ratio (IR), were calculated to evaluate homogeneity of air distribution. Experimental acute lung injury (ALI) was provoked in seven female pigs (German Landrace) by lipopolysaccharide (LPS). All animals suffered from experimental ALI 3 to 4 hours after LPS infusion. At defined time points, respiratory and hemodynamic parameters, blood gas analyses and EIT-recordings were performed. Eight hours after ALI, animals were euthanized. Stroke volume, derived from pulmonary artery catheter (PAC), decreased continuously up to four hours after ALI. Then, stroke volume increased slightly. Stroke volume, derived from the self-developed tool, showed the same characteristics (p=0.047, r = 0.365). In addition to the GII and IR individually, both classified scores showed a high correlation with the Horowitz Index, defined as p <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">a</sub> O <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> /FiO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> . To conclude, EIT-derived measures enabled a reliable estimation of cardiac stroke volume and regional distribution of ventilation.
Year
DOI
Venue
2017
10.1109/EMBC.2017.8036835
2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)
Keywords
Field
DocType
Acute Lung Injury,Animals,Electric Impedance,Female,Respiration, Artificial,Swine,Tomography
Stroke volume,Ventilation (architecture),Lung,Electronic engineering,Medicine,Hemodynamics,Internal medicine,Cardiology,Intensive care medicine,Lung ventilation,Cardiac output,Intensive care,Electrical impedance tomography
Conference
Volume
ISSN
ISBN
2017
1557-170X
978-1-5090-2810-8
Citations 
PageRank 
References 
0
0.34
0
Authors
4
Name
Order
Citations
PageRank
Nadine Hochhausen101.01
Henriette Dohmeier200.34
Rolf Rossaint3278.04
Michael Czaplik452.86