Abstract:
:Electrical impedance tomography (EIT) is expected to become a valuable tool for monitoring mechanically ventilated patients due to its ability to continuously assess regional lung ventilation and aeration. Several sources of interference with EIT examinations exist in intensive care units (ICU). Our objectives are to demonstrate how some medical nursing and monitoring devices interfere with EIT measurements and modify the EIT scans and waveforms, which approaches can be applied to minimize these effects and how possible misinterpretation can be avoided. We present four cases of EIT examinations of adult ICU patients. Two of the patients were subjected to pulsation therapy using a pulsating air suspension mattress while being ventilated by high-frequency oscillatory or conventional pressure-controlled ventilation, respectively. The EIT signal modulation synchronous with the occurrence of the pulsating wave was 2.3 times larger than the periodic modulation synchronous with heart rate and high-frequency oscillations. During conventional ventilation, the pulsating mattress induced an EIT signal fluctuation with a magnitude corresponding to about 20% of the patient's tidal volume. In the third patient, interference with EIT examination was caused by continuous cardiac output monitoring. The last patient's examination was disturbed by impedance pneumography when excitation currents of similar frequency to EIT were used. In all subjects, the generation of functional EIT scans was compromised and interpretation of regional ventilation impossible. Discontinuation of pulsation therapy and of continuous cardiac output and impedance respiration monitoring immediately improved the EIT signal and scan quality. Offline processing of the disturbed data using frequency filtering enabled partial retrieval of relevant information. We conclude that thoracic EIT examinations in the ICU require cautious interpretation because of possible mechanical and electromagnetic interference.
journal_name
Physiol Measjournal_title
Physiological measurementauthors
Frerichs I,Pulletz S,Elke G,Gawelczyk B,Frerichs A,Weiler Ndoi
10.1088/0967-3334/32/12/F01subject
Has Abstractpub_date
2011-12-01 00:00:00pages
L1-10issue
12eissn
0967-3334issn
1361-6579pii
S0967-3334(11)05941-7journal_volume
32pub_type
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