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Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS

Spinelli, E.; Kircher, M. 1; Stender, B.; Ottaviani, I.; Basile, M. C.; Marongiu, I.; Colussi, G.; Grasselli, G.; Pesenti, A.; Mauri, T.
1 Institut für Biomedizinische Technik (IBT), Karlsruher Institut für Technologie (KIT)

Abstract:

Background
In acute respiratory distress syndrome (ARDS), non-ventilated perfused regions coexist with non-perfused ventilated regions within lungs. The number of unmatched regions might reflect ARDS severity and affect the risk of ventilation-induced lung injury. Despite pathophysiological relevance, unmatched ventilation and perfusion are not routinely assessed at the bedside. The aims of this study were to quantify unmatched ventilation and perfusion at the bedside by electrical impedance tomography (EIT) investigating their association with mortality in patients with ARDS and to explore the effects of positive end-expiratory pressure (PEEP) on unmatched ventilation and perfusion in subgroups of patients with different ARDS severity based on PaO2/FiO2 and compliance.

Methods
Prospective observational study in 50 patients with mild (36%), moderate (46%), and severe (18%) ARDS under clinical ventilation settings. EIT was applied to measure the regional distribution of ventilation and perfusion using central venous bolus of saline 5% during end-inspiratory pause. We defined unmatched units as the percentage of only ventilated units plus the percentage of only perfused units.
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Verlagsausgabe §
DOI: 10.5445/IR/1000133970
Veröffentlicht am 20.09.2021
Originalveröffentlichung
DOI: 10.1186/s13054-021-03615-4
Scopus
Zitationen: 45
Web of Science
Zitationen: 41
Dimensions
Zitationen: 54
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Biomedizinische Technik (IBT)
Publikationstyp Zeitschriftenaufsatz
Publikationsjahr 2021
Sprache Englisch
Identifikator ISSN: 1364-8535, 1466-609X
KITopen-ID: 1000133970
Erschienen in Critical Care
Verlag Springer Fachmedien Wiesbaden
Band 25
Heft 1
Seiten 192
Nachgewiesen in Dimensions
Web of Science
Scopus
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