Electrical impedence tomography and heterogeneity of pulmonary perfusion and ventilation in porcine acute lung injury.

2.50
Hdl Handle:
http://hdl.handle.net/2336/86498
Title:
Electrical impedence tomography and heterogeneity of pulmonary perfusion and ventilation in porcine acute lung injury.
Authors:
Fagerberg, A; Söndergaard, S; Karason, S; Aneman, A
Citation:
Acta Anaesthesiol Scand. 2009, 53(10):1300-9
Issue Date:
1-Nov-2009
Abstract:
BACKGROUND: The heterogeneity of pulmonary ventilation (V), perfusion (Q) and V/Q matching impairs gas exchange in an acute lung injury (ALI). This study investigated the feasibility of electrical impedance tomography (EIT) to assess the V/Q distribution and matching during an endotoxinaemic ALI in pigs. METHODS: Mechanically ventilated, anaesthetised pigs (n=11, weight 30-36 kg) were studied during an infusion of endotoxin for 150 min. Impedance changes related to ventilation (Z(V)) and perfusion (Z(Q)) were monitored globally and bilaterally in four regions of interest (ROIs) of the EIT image. The distribution and ratio of Z(V) and Z(Q) were assessed. The alveolar-arterial oxygen difference, venous admixture, fractional alveolar dead space and functional residual capacity (FRC) were recorded, together with global and regional lung compliances and haemodynamic parameters. Values are mean+/-standard deviation (SD) and regression coefficients. RESULTS: Endotoxinaemia increased the heterogeneity of Z(Q) but not Z(V). Lung compliance progressively decreased with a ventral redistribution of Z(V). A concomitant dorsal redistribution of Z(Q) resulted in mismatch of global (from Z(V)/Z(Q) 1.1+/-0.1 to 0.83+/-0.3) and notably dorsal (from Z(V)/Z(Q) 0.86+/-0.4 to 0.51+/-0.3) V and Q. Changes in global Z(V)/Z(Q) correlated with changes in the alveolar-arterial oxygen difference (r(2)=0.65, P<0.05), venous admixture (r(2)=0.66, P<0.05) and fractional alveolar dead space (r(2)=0.61, P<0.05). Decreased end-expiratory Z(V) correlated with decreased FRC (r(2)=0.74, P<0.05). CONCLUSIONS: EIT can be used to assess the heterogeneity of regional pulmonary ventilation and perfusion and V/Q matching during endotoxinaemic ALI, identifying pivotal pathophysiological changes.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://dx.doi.org/10.1111/j.1399-6576.2009.02103.x

Full metadata record

DC FieldValue Language
dc.contributor.authorFagerberg, Aen
dc.contributor.authorSöndergaard, Sen
dc.contributor.authorKarason, Sen
dc.contributor.authorAneman, Aen
dc.date.accessioned2009-11-19T15:03:31Z-
dc.date.available2009-11-19T15:03:31Z-
dc.date.issued2009-11-01-
dc.date.submitted2009-11-19-
dc.identifier.citationActa Anaesthesiol Scand. 2009, 53(10):1300-9en
dc.identifier.issn1399-6576-
dc.identifier.pmid19719814-
dc.identifier.doi10.1111/j.1399-6576.2009.02103.x-
dc.identifier.urihttp://hdl.handle.net/2336/86498-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: The heterogeneity of pulmonary ventilation (V), perfusion (Q) and V/Q matching impairs gas exchange in an acute lung injury (ALI). This study investigated the feasibility of electrical impedance tomography (EIT) to assess the V/Q distribution and matching during an endotoxinaemic ALI in pigs. METHODS: Mechanically ventilated, anaesthetised pigs (n=11, weight 30-36 kg) were studied during an infusion of endotoxin for 150 min. Impedance changes related to ventilation (Z(V)) and perfusion (Z(Q)) were monitored globally and bilaterally in four regions of interest (ROIs) of the EIT image. The distribution and ratio of Z(V) and Z(Q) were assessed. The alveolar-arterial oxygen difference, venous admixture, fractional alveolar dead space and functional residual capacity (FRC) were recorded, together with global and regional lung compliances and haemodynamic parameters. Values are mean+/-standard deviation (SD) and regression coefficients. RESULTS: Endotoxinaemia increased the heterogeneity of Z(Q) but not Z(V). Lung compliance progressively decreased with a ventral redistribution of Z(V). A concomitant dorsal redistribution of Z(Q) resulted in mismatch of global (from Z(V)/Z(Q) 1.1+/-0.1 to 0.83+/-0.3) and notably dorsal (from Z(V)/Z(Q) 0.86+/-0.4 to 0.51+/-0.3) V and Q. Changes in global Z(V)/Z(Q) correlated with changes in the alveolar-arterial oxygen difference (r(2)=0.65, P<0.05), venous admixture (r(2)=0.66, P<0.05) and fractional alveolar dead space (r(2)=0.61, P<0.05). Decreased end-expiratory Z(V) correlated with decreased FRC (r(2)=0.74, P<0.05). CONCLUSIONS: EIT can be used to assess the heterogeneity of regional pulmonary ventilation and perfusion and V/Q matching during endotoxinaemic ALI, identifying pivotal pathophysiological changes.en
dc.language.isoenen
dc.publisherWiley-Blackwellen
dc.relation.urlhttp://dx.doi.org/10.1111/j.1399-6576.2009.02103.xen
dc.subject.meshPulmonary Ventilationen
dc.subject.meshPerfusionen
dc.subject.meshTomographyen
dc.subject.meshElectric Impedanceen
dc.titleElectrical impedence tomography and heterogeneity of pulmonary perfusion and ventilation in porcine acute lung injury.en
dc.typeArticleen
dc.contributor.departmentDepartment of Anaesthesiology and Intensive Care, Sahlgrenska University Hospital, Blå Stråket 5, Gothenburg, Sweden.en
dc.identifier.journalActa anaesthesiologica Scandinavicaen

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