Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study

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Autor(a) principal: Rossi, Felipe de Souza
Data de Publicação: 2013
Outros Autores: Yagui, Ana Cristina Zanon, Haddad, Luciana Branco, Deutsch, Alice D'Agostini, Rebello, Celso Moura
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/72132
Resumo: OBJECTIVES: Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH2O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomography to determine the feasibility of evaluating the positive end-expiratory pressure level associated with a more homogeneous air distribution within the lungs before extubation. METHODS: Ventilation homogeneity was defined by electrical impedance tomography as the ratio of ventilation between dependent and non-dependent lung areas. The best ventilation homogeneity was achieved when this ratio was equal to 1. Just before extubation, decremental expiratory pressure levels were applied (8, 7, 6 and 5 cmH(2)0; 3 minutes each step), and the pressure that determined the best ventilation homogeneity was defined as the best positive end-expiratory pressure. RESULTS: The best positive end-expiratory pressure value was 6.3 ± 1.1 cmH(2)0, and the mean continuous positive airway pressure applied after extubation was 5.2 ± 0.4 cmH(2)0 (p = 0.002). The extubation failure rate was 21.4%. X-Ray and blood gases after extubation were also checked. CONCLUSION: This study demonstrates that electrical impedance tomography can be safely and successfully used in patients ready for extubation to suggest the best ventilation homogeneity, which is influenced by the level of expiratory pressure applied. In this feasibility study, the best lung compliance was found with pressure levels higher than the continuous positive airway pressure levels that are usually applied for routine extubation.
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spelling Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility studyInfantPrematureElectric ImpedanceContinuous Positive Airway PressureOBJECTIVES: Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH2O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomography to determine the feasibility of evaluating the positive end-expiratory pressure level associated with a more homogeneous air distribution within the lungs before extubation. METHODS: Ventilation homogeneity was defined by electrical impedance tomography as the ratio of ventilation between dependent and non-dependent lung areas. The best ventilation homogeneity was achieved when this ratio was equal to 1. Just before extubation, decremental expiratory pressure levels were applied (8, 7, 6 and 5 cmH(2)0; 3 minutes each step), and the pressure that determined the best ventilation homogeneity was defined as the best positive end-expiratory pressure. RESULTS: The best positive end-expiratory pressure value was 6.3 ± 1.1 cmH(2)0, and the mean continuous positive airway pressure applied after extubation was 5.2 ± 0.4 cmH(2)0 (p = 0.002). The extubation failure rate was 21.4%. X-Ray and blood gases after extubation were also checked. CONCLUSION: This study demonstrates that electrical impedance tomography can be safely and successfully used in patients ready for extubation to suggest the best ventilation homogeneity, which is influenced by the level of expiratory pressure applied. In this feasibility study, the best lung compliance was found with pressure levels higher than the continuous positive airway pressure levels that are usually applied for routine extubation.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2013-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/7213210.1590/clin.v68i3.72132Clinics; Vol. 68 No. 3 (2013); 345-350Clinics; v. 68 n. 3 (2013); 345-350Clinics; Vol. 68 Núm. 3 (2013); 345-3501980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/72132/75367Rossi, Felipe de SouzaYagui, Ana Cristina ZanonHaddad, Luciana BrancoDeutsch, Alice D'AgostiniRebello, Celso Mourainfo:eu-repo/semantics/openAccess2014-01-28T17:05:36Zoai:revistas.usp.br:article/72132Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2014-01-28T17:05:36Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
title Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
spellingShingle Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
Rossi, Felipe de Souza
Infant
Premature
Electric Impedance
Continuous Positive Airway Pressure
title_short Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
title_full Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
title_fullStr Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
title_full_unstemmed Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
title_sort Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
author Rossi, Felipe de Souza
author_facet Rossi, Felipe de Souza
Yagui, Ana Cristina Zanon
Haddad, Luciana Branco
Deutsch, Alice D'Agostini
Rebello, Celso Moura
author_role author
author2 Yagui, Ana Cristina Zanon
Haddad, Luciana Branco
Deutsch, Alice D'Agostini
Rebello, Celso Moura
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Rossi, Felipe de Souza
Yagui, Ana Cristina Zanon
Haddad, Luciana Branco
Deutsch, Alice D'Agostini
Rebello, Celso Moura
dc.subject.por.fl_str_mv Infant
Premature
Electric Impedance
Continuous Positive Airway Pressure
topic Infant
Premature
Electric Impedance
Continuous Positive Airway Pressure
description OBJECTIVES: Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH2O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomography to determine the feasibility of evaluating the positive end-expiratory pressure level associated with a more homogeneous air distribution within the lungs before extubation. METHODS: Ventilation homogeneity was defined by electrical impedance tomography as the ratio of ventilation between dependent and non-dependent lung areas. The best ventilation homogeneity was achieved when this ratio was equal to 1. Just before extubation, decremental expiratory pressure levels were applied (8, 7, 6 and 5 cmH(2)0; 3 minutes each step), and the pressure that determined the best ventilation homogeneity was defined as the best positive end-expiratory pressure. RESULTS: The best positive end-expiratory pressure value was 6.3 ± 1.1 cmH(2)0, and the mean continuous positive airway pressure applied after extubation was 5.2 ± 0.4 cmH(2)0 (p = 0.002). The extubation failure rate was 21.4%. X-Ray and blood gases after extubation were also checked. CONCLUSION: This study demonstrates that electrical impedance tomography can be safely and successfully used in patients ready for extubation to suggest the best ventilation homogeneity, which is influenced by the level of expiratory pressure applied. In this feasibility study, the best lung compliance was found with pressure levels higher than the continuous positive airway pressure levels that are usually applied for routine extubation.
publishDate 2013
dc.date.none.fl_str_mv 2013-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/72132
10.1590/clin.v68i3.72132
url https://www.revistas.usp.br/clinics/article/view/72132
identifier_str_mv 10.1590/clin.v68i3.72132
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/72132/75367
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 68 No. 3 (2013); 345-350
Clinics; v. 68 n. 3 (2013); 345-350
Clinics; Vol. 68 Núm. 3 (2013); 345-350
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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