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成人 ICU 患者的电阻抗断层成像监测:现状、标准化采集、处理和临床应用的建议及未来方向。

Electrical impedance tomography monitoring in adult ICU patients: state-of-the-art, recommendations for standardized acquisition, processing, and clinical use, and future directions.

机构信息

Department of Translational Medicine, University of Ferrara, Ferrara, Italy.

Medical Intensive Care Unit, Vent'Lab, Angers University Hospital, University of Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France.

出版信息

Crit Care. 2024 Nov 19;28(1):377. doi: 10.1186/s13054-024-05173-x.

Abstract

Electrical impedance tomography (EIT) is an emerging technology for the non-invasive monitoring of regional distribution of ventilation and perfusion, offering real-time and continuous data that can greatly enhance our understanding and management of various respiratory conditions and lung perfusion. Its application may be especially beneficial for critically ill mechanically ventilated patients. Despite its potential, clear evidence of clinical benefits is still lacking, in part due to a lack of standardization and transparent reporting, which is essential for ensuring reproducible research and enhancing the use of EIT for personalized mechanical ventilation. This report is the result of a four-day expert meeting where we aimed to promote the consistent and reliable use of EIT, facilitating its integration into both clinical practice and research, focusing on the adult intensive care patient. We discuss the state-of-the-art regarding EIT acquisition and processing, applications during controlled ventilation and spontaneous breathing, ventilation-perfusion assessment, and novel future directions.

摘要

电阻抗断层成像(EIT)是一种新兴的技术,可用于非侵入式监测通气和灌注的区域性分布,提供实时和连续的数据,可极大地增强我们对各种呼吸状况和肺灌注的理解和管理。其应用对于机械通气的重症患者可能特别有益。尽管具有潜力,但仍缺乏明确的临床获益证据,部分原因是缺乏标准化和透明的报告,这对于确保可重复性研究和增强 EIT 在个性化机械通气中的应用至关重要。本报告是为期四天的专家会议的结果,旨在促进 EIT 的一致和可靠使用,促进其在临床实践和研究中的整合,重点关注成年重症监护患者。我们讨论了 EIT 采集和处理的最新技术、在控制通气和自主呼吸期间的应用、通气-灌注评估以及新的未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e361/11577873/c36abae8a75e/13054_2024_5173_Fig1_HTML.jpg

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