Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Physiol Meas. 2019 Jun 4;40(5):054001. doi: 10.1088/1361-6579/ab1946.
Chest electrical impedance tomography (EIT) is currently applied in neonatal and paediatric patients, mainly within clinical studies. The findings of these studies imply that lung monitoring using EIT provides valuable information on regional lung ventilation and aeration at the bedside that might improve the therapy and care of this fragile patient population. In view of this postulated future use of EIT in neonatology and paediatrics we have conducted an international survey to assess the perceived usefulness of several measures derived from EIT examinations.
A questionnaire validating the clinical usefulness of 14 previously described EIT measures was designed and sent to 36 clinicians with previous experience with EIT in neonatal and paediatric patients. A numerical rating scale was used to assess the usefulness of each measure.
Thirty-four clinicians from 12 countries responded to the invitation and 32 filled in the questionnaire. The mean clinical and EIT experience (±SD) of the respondents was 19.4 ± 9.1 years and 7.7 ± 5.8 years, respectively. The top-rated measures were the global inhomogeneity index, silent spaces, change in end-expiratory lung impedance and ventrodorsal centre of ventilation. The bottom-rated were the regional respiratory time constant, tidal volume normalised to ml, respiratory rate and heart rate on the last rank.
The survey revealed that EIT measures characterising the ventilation and aeration distribution and the degree of their heterogeneity were deemed particularly useful. Respiratory rate, heart rate and overall tidal volume were considered less useful probably because these parameters are already routinely assessed by other conventional methods.
胸部电阻抗断层成像(EIT)目前应用于新生儿和儿科患者,主要在临床研究中。这些研究的结果表明,EIT 肺部监测可提供床边区域肺通气和充气的有价值信息,可能改善该脆弱患者群体的治疗和护理。鉴于 EIT 在新生儿学和儿科学中的未来应用,我们进行了一项国际调查,以评估从 EIT 检查中得出的几种测量方法的预期有用性。
设计了一份验证 14 种先前描述的 EIT 测量方法临床有用性的问卷,并分发给 36 名在新生儿和儿科患者中具有 EIT 经验的临床医生。使用数字评分量表评估每个测量方法的有用性。
来自 12 个国家的 34 名临床医生对邀请做出了回应,其中 32 名填写了问卷。受访者的平均临床和 EIT 经验(±SD)分别为 19.4±9.1 年和 7.7±5.8 年。评分最高的测量方法是全局不均匀指数、无声空间、呼气末肺阻抗变化和通气的腹背中心。评分最低的是区域呼吸时间常数、以 ml 归一化的潮气量、呼吸频率和心率。
调查显示,用于描述通气和充气分布及其异质性程度的 EIT 测量方法被认为特别有用。呼吸频率、心率和总体潮气量被认为不太有用,可能是因为这些参数已经通过其他常规方法进行了常规评估。