Helping students to understand physiological aspects of regional distribution of ventilation in humans: a experience from the electrical impedance tomography

Adv Physiol Educ. 2018 Dec 1;42(4):655-660. doi: 10.1152/advan.00086.2018.

Abstract

Undergraduate biomedical students often have difficulties in understanding basic concepts of respiratory physiology, particularly respiratory mechanics. In this study, we report the use of electrical impedance tomography (EIT) to improve and consolidate the knowledge about physiological aspects of normal regional distribution of ventilation in humans. Initially, we assessed the previous knowledge of a group of medical students ( n = 39) about regional differences in lung ventilation. Thereafter, we recorded the regional distribution of ventilation through surface electrodes on a healthy volunteer adopting four different decubitus positions: supine, prone, and right and left lateral. The recordings clearly showed greater pulmonary ventilation in the dependent lung, mainly in the lateral decubitus. Considering the differences in pulmonary ventilation between right and left lateral decubitus, only 33% of students were able to notice it correctly beforehand. This percentage increased to 84 and 100%, respectively ( P < 0.01), after the results of the ventilation measurements obtained with EIT were examined and discussed. A self-assessment questionnaire showed that students considered the practical activity as an important tool to assist in the understanding of the basic concepts of respiratory mechanics. Experimental demonstration of the physiological variations of regional lung ventilation in volunteers by using EIT is feasible, effective, and stimulating for undergraduate medical students. Therefore, this practical activity may help faculty and students to overcome the challenges in the field of respiratory physiology learning.

Keywords: breathing mechanics; electrical impedance tomography; laboratory syllabus; physiology education; postural changes; ventilation-perfusion mismatch.

MeSH terms

  • Comprehension / physiology
  • Education, Medical / methods*
  • Electric Impedance*
  • Female
  • Humans
  • Male
  • Physiology / education*
  • Pulmonary Ventilation / physiology*
  • Students, Medical*
  • Tomography / methods*
  • Young Adult