Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Acute Respiratory and Critical Illness Center (ARCI), Santiago, Chile.
Crit Care. 2018 Oct 25;22(1):263. doi: 10.1186/s13054-018-2195-6.
Acute respiratory distress syndrome (ARDS) is a clinical entity that acutely affects the lung parenchyma, and is characterized by diffuse alveolar damage and increased pulmonary vascular permeability. Currently, computed tomography (CT) is commonly used for classifying and prognosticating ARDS. However, performing this examination in critically ill patients is complex, due to the need to transfer these patients to the CT room. Fortunately, new technologies have been developed that allow the monitoring of patients at the bedside. Electrical impedance tomography (EIT) is a monitoring tool that allows one to evaluate at the bedside the distribution of pulmonary ventilation continuously, in real time, and which has proven to be useful in optimizing mechanical ventilation parameters in critically ill patients. Several clinical applications of EIT have been developed during the last years and the technique has been generating increasing interest among researchers. However, among clinicians, there is still a lack of knowledge regarding the technical principles of EIT and potential applications in ARDS patients. The aim of this review is to present the characteristics, technical concepts, and clinical applications of EIT, which may allow better monitoring of lung function during ARDS.
急性呼吸窘迫综合征(ARDS)是一种急性影响肺实质的临床实体,其特征为弥漫性肺泡损伤和肺血管通透性增加。目前,计算机断层扫描(CT)常用于 ARDS 的分类和预后评估。然而,由于需要将这些患者转移到 CT 室,因此对重症患者进行这项检查很复杂。幸运的是,已经开发出了新技术,可以在床边对患者进行监测。电阻抗断层成像(EIT)是一种监测工具,可在床边实时连续评估肺通气的分布,已被证明在优化重症患者机械通气参数方面非常有用。在过去几年中已经开发出了 EIT 的几种临床应用,该技术在研究人员中引起了越来越多的兴趣。然而,在临床医生中,对于 EIT 的技术原理以及在 ARDS 患者中的潜在应用仍然知之甚少。本文旨在介绍 EIT 的特点、技术概念和临床应用,这可能有助于更好地监测 ARDS 期间的肺功能。