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No change in the regional distribution of tidal volume during lateral posture in mechanically ventilated patients assessed by electrical impedance tomography
Author(s) -
Bein Thomas,
Ploner Franz,
Ritzka Markus,
Pfeifer Michael,
Schlitt Hans J.,
Graf Bernhard M.
Publication year - 2010
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2010.00933.x
Subject(s) - supine position , medicine , tidal volume , electrical impedance tomography , ventilation (architecture) , lung volumes , nuclear medicine , tomography , lung , anatomy , anesthesia , radiology , respiratory system , physics , meteorology
Summary We assessed the distribution of regional lung ventilation during moderate and steep lateral posture using electrical impedance tomography (EIT) in mechanically ventilated patients. Seven patients were placed on a kinetic treatment table. An elastic belt containing 16 electrodes was placed around the chest and was connected to the EIT device. Patients were moved to left and right lateral positions in a stepwise (10°) mode up to 60°. EIT images [arbitrary units (AU)] were generated and scanned for assessment of relative ventilation distribution changes [tidal volume ( V T )]. A calibration procedure of arbitrary units (AUs) versus ventilator‐derived V T performed in all patients during three predefined positions (supine, 60°‐left dependent and 60°‐right‐dependent) showed a significant correlation between V T in supine, left and right lateral positions with the corresponding AUs ( r 2 = 0·356, P <0·05). Changes in V T were calculated and compared to supine position, and specific regions of interest (ROIs) were analysed. In our study, in contrast to recent findings, a change in lateral positions did not induce a significant change in regional tidal volume distribution. In right lateral positions, a broader variation of V T with a trend towards an increase in the dependently positioned lung was observed in comparison with supine. Lateral positioning promotes the redistribution of ventilation to the ventral regions of the lung. The use of EIT technology might become a helpful tool for understanding and guiding posture therapy in mechanically ventilated patients.