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Chest. 1999 Dec;116(6):1695-702.

Electrical impedance tomography in the assessment of extravascular lung water in noncardiogenic acute respiratory failure.

Author information

1
Department of Pulmonary Medicine, Hospital Centre Apeldorn, The Netherlands.

Abstract

STUDY OBJECTIVES:

To establish the value of electrical impedance tomography (EIT) in assessing pulmonary edema in noncardiogenic acute respiratory failure (ARF), as compared to the thermal dye double indicator dilution technique (TDD).

DESIGN:

Prospective clinical study.

SETTING:

ICU of a general hospital.

PATIENTS:

Fourteen ARF patients.

INTERVENTIONS:

In order to use the TDD to determine the amount of extravascular lung water (EVLW), a fiberoptic catheter was placed in the femoral artery.

MEASUREMENTS AND MAIN RESULTS:

Fourteen consecutive ARF patients receiving mechanical ventilation were measured by EIT and TDD. EIT visualizes the impedance changes caused by the ventilation in two-dimensional image planes. An impedance ratio (IR) of the ventilation-induced impedance changes of a posterior and an anterior part of the lungs was used to indicate the amount of EVLW. For the 29 measurements in 14 patients, a significant correlation between EIT and TDD (r = 0. 85; p < 0.001) was found. The EIT reproducibility was good. The diagnostic value of the method was tested by receiver operator characteristic analysis, with 10 mL/kg of EVLW considered as the upper limit of normal. At a cutoff level of the IR of 0.64, the IR had a sensitivity of 93%, a specificity of 87%, and a positive predictive value of 87% for a supranormal amount of EVLW. Follow-up measurements were performed in 11 patients. A significant correlation was found between the changes in EVLW measured with EIT and TDD (r = 0.85; p < 0.005).

CONCLUSION:

We conclude that EIT is a noninvasive technique for reasonably estimating the amount of EVLW in noncardiogenic ARF.

PMID:
10593797
DOI:
10.1378/chest.116.6.1695
[Indexed for MEDLINE]

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