Ako Ako A, Ismaiel Ahmed, Rastogi Shantanu
Division of Neonatology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, 10467, USA.
Pediatr Res. 2025 Feb 22. doi: 10.1038/s41390-025-03929-x.
Appropriate interventions informed by real-time assessment of pulmonary function in mechanically ventilated critically ill neonates can reduce the incidence of bronchopulmonary dysplasia, pneumothorax, intraventricular hemorrhage and other complications of newborn life. The respiratory system in neonates is uniquely different from older children, and its physiological and anatomic attributes increase neonatal vulnerability to respiratory distress and eventual failure. While significant advancements have been made in developing respiratory support for neonates, such support is accompanied by inherent risks to their delicate lungs. Ventilator-associated lung injury poses a critical concern that can be potentially decreased with more precise, non-invasive, non-radiating, bedside methods for assessing neonatal pulmonary function in real time. Electrical impedance tomography (EIT) is one such tool, with immense potential for real-time pulmonary function monitoring in neonates. Still relatively new and in the earliest stages of clinical adoption, EIT use in neonatal critical care has been reported in several studies. This review discusses the basic features of EIT, its distinct advantages over traditional pulmonary function monitoring tools, the scope of its adoption in neonatal clinical practice, challenges associated with clinical adoption, and prospects for future applications. IMPACT: 1. Individualized care assisted by bedside pulmonary function monitoring can positively impact neonatal critical care and outcomes. 2. Electrical impedance tomography (EIT) has the potential to improve neonatal pulmonary function monitoring and treatment outcomes. 3. Electrical impedance tomography can be adopted as a part of routine neonatal respiratory critical care, especially in the population of patients most at risk for bronchopulmonary dysplasia and acute respiratory complications.
通过对机械通气的危重新生儿的肺功能进行实时评估来采取适当的干预措施，可以降低支气管肺发育不良、气胸、脑室内出血及其他新生儿期并发症的发生率。新生儿的呼吸系统与大龄儿童有独特的差异，其生理和解剖特性增加了新生儿发生呼吸窘迫及最终呼吸衰竭的易感性。虽然在为新生儿开发呼吸支持方面已取得显著进展，但这种支持对其娇嫩的肺部存在固有风险。呼吸机相关性肺损伤是一个关键问题，采用更精确、无创、无辐射的床旁方法实时评估新生儿肺功能可能会降低这一风险。电阻抗断层成像（EIT）就是这样一种工具，在新生儿实时肺功能监测方面具有巨大潜力。EIT仍然相对较新，尚处于临床应用的早期阶段，已有多项研究报道了其在新生儿重症监护中的应用。本文综述讨论了EIT的基本特征、相对于传统肺功能监测工具的独特优势、在新生儿临床实践中的应用范围、临床应用相关的挑战以及未来应用前景。影响：1. 床旁肺功能监测辅助的个体化护理可对新生儿重症监护及预后产生积极影响。2. 电阻抗断层成像（EIT）有潜力改善新生儿肺功能监测及治疗效果。3. 电阻抗断层成像可作为新生儿呼吸重症监护常规的一部分，尤其是在支气管肺发育不良和急性呼吸并发症风险最高的患者群体中。
