TY - JOUR
T1 - Electrical impedance tomography in the assessment of extravascular lung water in noncardiogenic acute respiratory failure
AU - Kunst, Peter W.A.
AU - Vonk Noordegraaf, Anton
AU - Raaijmakers, Esther
AU - Bakker, Jan
AU - Johan Groeneveld, A. B.
AU - Postmus, Piet E.
AU - De Vries, Peter M.J.M.
PY - 1999/1/1
Y1 - 1999/1/1
N2 - Study objectives: To establish the value of electrical impedance tomography (EIT) in assessing pulmonary edema in noncardiogenic acute respiratory failure (ARF), as compared to the thermal dye double indicator dilution technique (TDD). Design: Prospective clinical study. Setting: ICU of a general hospital. Patients: Fourteen ARF patients. Interventions: In order to use the TDD to determine the amount of extravascular lung water (EVLW), a fiberoptic catheter was placed in the femoral artery. Measurements and main results: Fourteen consecutive ARF patients receiving mechanical ventilation were measured by EIT and TDD. EIT visualizes the impedance changes caused by the ventilation in two-dimensional image planes. An impedance ratio (IR) of the ventilation-induced impedance changes of a posterior and an anterior part of the lungs was used to indicate the amount of EVLW. For the 29 measurements in 14 patients, a significant correlation between EIT and TDD (r = 0.85; p< 0.001) was found. The EIT reproducibility was good. The diagnostic value of the method was tested by receiver operator characteristic analysis, with 10 mL/kg of EVLW considered as the upper limit of normal. At a cutoff level of the IR of 0.64, the IR had a sensitivity of 93%, a specificity of 87%, and a positive predictive value of 87% for a supranormal amount of EVLW. Follow-up measurements were performed in 11 patients. A significant correlation was found between the changes in EVLW measured with EIT and TDD (r = 0.85; p < 0.005). Conclusion: We conclude that EIT is a noninvasive technique for reasonably estimating the amount of EVLW in noncardiogenic ARF.
AB - Study objectives: To establish the value of electrical impedance tomography (EIT) in assessing pulmonary edema in noncardiogenic acute respiratory failure (ARF), as compared to the thermal dye double indicator dilution technique (TDD). Design: Prospective clinical study. Setting: ICU of a general hospital. Patients: Fourteen ARF patients. Interventions: In order to use the TDD to determine the amount of extravascular lung water (EVLW), a fiberoptic catheter was placed in the femoral artery. Measurements and main results: Fourteen consecutive ARF patients receiving mechanical ventilation were measured by EIT and TDD. EIT visualizes the impedance changes caused by the ventilation in two-dimensional image planes. An impedance ratio (IR) of the ventilation-induced impedance changes of a posterior and an anterior part of the lungs was used to indicate the amount of EVLW. For the 29 measurements in 14 patients, a significant correlation between EIT and TDD (r = 0.85; p< 0.001) was found. The EIT reproducibility was good. The diagnostic value of the method was tested by receiver operator characteristic analysis, with 10 mL/kg of EVLW considered as the upper limit of normal. At a cutoff level of the IR of 0.64, the IR had a sensitivity of 93%, a specificity of 87%, and a positive predictive value of 87% for a supranormal amount of EVLW. Follow-up measurements were performed in 11 patients. A significant correlation was found between the changes in EVLW measured with EIT and TDD (r = 0.85; p < 0.005). Conclusion: We conclude that EIT is a noninvasive technique for reasonably estimating the amount of EVLW in noncardiogenic ARF.
KW - ARDS
KW - Electrical impedance
KW - Extravascular lung water
KW - Thermal dye dilution
KW - Tomography
UR - http://www.scopus.com/inward/record.url?scp=0033385742&partnerID=8YFLogxK
U2 - https://doi.org/10.1378/chest.116.6.1695
DO - https://doi.org/10.1378/chest.116.6.1695
M3 - Article
C2 - 10593797
SN - 0012-3692
VL - 116
SP - 1695
EP - 1702
JO - Chest
JF - Chest
IS - 6
ER -