Białka Szymon, Copik Maja, Rybczyk Katarzyna, Misiołek Hanna
Department of Anaesthesiology and Intensive Care, Faculty of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland.
Anaesthesiol Intensive Ther. 2017;49(3):222-226. doi: 10.5603/AIT.2017.0040.
The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan. After identifying the causing factor (Pneumocyctis jiroveci), EIT monitoring was maintained to assess the effectiveness of targeted microbial treatment. In the following days, we observed an improvement of regional ventilation of the upper and middle segments of the left lung that corresponded well with laboratory test results, especially arterial blood gas analysis. The use of Electrical Impedance Tomography enables non-invasive, bedside, continuous assessment of regional lung ventilation. It is possible to use it in both mechanically ventilated and spontaneously breathing patients. It allows efficient and dynamic monitoring of the course of the therapeutic process. Interpretation of the results is relatively easy to learn and does not require specialist knowledge. Moreover, it is possible to use EIT in those cases where other methods are of high risk or contraindicated.
本文旨在描述将电阻抗断层扫描(EIT)用作重症监护病房(ICU)治疗监测工具的可能性。它基于病例报告和文献综述。一名19岁女性因严重急性呼吸窘迫综合征入住ICU。尽管进行了积极治疗,但病情并无改善。由于将患者转运至放射科进行对照CT扫描存在困难,我们决定使用EIT进行治疗监测。在确定病因(耶氏肺孢子菌)后,持续进行EIT监测以评估针对性微生物治疗的效果。在接下来的几天里,我们观察到左肺上叶和中叶的区域通气有所改善,这与实验室检查结果,尤其是动脉血气分析结果高度相符。电阻抗断层扫描的使用能够对区域肺通气进行无创、床边、连续评估。它可用于机械通气患者和自主呼吸患者。它能够对治疗过程进行高效、动态的监测。结果解读相对容易掌握,且不需要专业知识。此外,在其他方法具有高风险或禁忌的情况下也可以使用EIT。