Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
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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Clinics |
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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 |
_version_ |
1800222759799750656 |