Background: Electrical impedance tomography (EIT) with indicator dilution may be clinically useful to measure relative lung perfusion, but there is limited information on the performance of this technique. Methods: Thirteen pigs (50–66 kg) were anaesthetised and mechanically ventilated. Sequential changes in ventilation were made: (i) right-lung ventilation with left-lung collapse, (ii) two-lung ventilation with optimised PEEP, (iii) two-lung ventilation with zero PEEP after saline lung lavage, (iv) two-lung ventilation with maximum PEEP (20/25 cm H2O to achieve peak airway pressure 45 cm H2O), and (v) two-lung ventilation under unilateral pulmonary artery occlusion. Relative lung perfusion was assessed with EIT and central venous injection of saline 3%, 5%, and 10% (10 ml) during breath holds. Relative perfusion was determined by positron emission tomography (PET) using 68Gallium-labelled microspheres. EIT and PET were compared in eight regions of equal ventro-dorsal height (right, left, ventral, mid-ventral, mid-dorsal, and dorsal), and directional changes in regional perfusion were determined. Results: Differences between methods were relatively small (95% of values differed by less than 8.7%, 8.9%, and 9.5% for saline 10%, 5%, and 3%, respectively). Compared with PET, EIT underestimated relative perfusion in dependent, and overestimated it in non-dependent, regions. EIT and PET detected the same direction of change in relative lung perfusion in 68.9–95.9% of measurements. Conclusions: The agreement between EIT and PET for measuring and tracking changes of relative lung perfusion was satisfactory for clinical purposes. Indicator-based EIT may prove useful for measuring pulmonary perfusion at bedside.

Measurement of relative lung perfusion with electrical impedance and positron emission tomography : an experimental comparative study in pigs / T. Bluth, T. Kiss, M. Kircher, A. Braune, C. Bozsak, R. Huhle, M. Scharffenberg, M. Herzog, J. Roegner, P. Herzog, L. Vivona, M. Millone, O. Dossel, M. Andreeff, T. Koch, J. Kotzerke, B. Stender, M. Gama de Abreu. - In: BRITISH JOURNAL OF ANAESTHESIA. - ISSN 0007-0912. - 123:2(2019 Aug), pp. 246-254.

Measurement of relative lung perfusion with electrical impedance and positron emission tomography : an experimental comparative study in pigs

Vivona L.;
2019-08

Abstract

Background: Electrical impedance tomography (EIT) with indicator dilution may be clinically useful to measure relative lung perfusion, but there is limited information on the performance of this technique. Methods: Thirteen pigs (50–66 kg) were anaesthetised and mechanically ventilated. Sequential changes in ventilation were made: (i) right-lung ventilation with left-lung collapse, (ii) two-lung ventilation with optimised PEEP, (iii) two-lung ventilation with zero PEEP after saline lung lavage, (iv) two-lung ventilation with maximum PEEP (20/25 cm H2O to achieve peak airway pressure 45 cm H2O), and (v) two-lung ventilation under unilateral pulmonary artery occlusion. Relative lung perfusion was assessed with EIT and central venous injection of saline 3%, 5%, and 10% (10 ml) during breath holds. Relative perfusion was determined by positron emission tomography (PET) using 68Gallium-labelled microspheres. EIT and PET were compared in eight regions of equal ventro-dorsal height (right, left, ventral, mid-ventral, mid-dorsal, and dorsal), and directional changes in regional perfusion were determined. Results: Differences between methods were relatively small (95% of values differed by less than 8.7%, 8.9%, and 9.5% for saline 10%, 5%, and 3%, respectively). Compared with PET, EIT underestimated relative perfusion in dependent, and overestimated it in non-dependent, regions. EIT and PET detected the same direction of change in relative lung perfusion in 68.9–95.9% of measurements. Conclusions: The agreement between EIT and PET for measuring and tracking changes of relative lung perfusion was satisfactory for clinical purposes. Indicator-based EIT may prove useful for measuring pulmonary perfusion at bedside.
electrical impedance tomography; indicator dilution; positron emission tomography; regional pulmonary perfusion; Animals; Disease Models, Animal; Electric Impedance; Lung; Pulmonary Ventilation; Swine; Positron-Emission Tomography; Respiration, Artificial
Settore MED/41 - Anestesiologia
BRITISH JOURNAL OF ANAESTHESIA
Article (author)
File in questo prodotto:
File Dimensione Formato  
BJA_2019_Bluth_1-s2.0-S0007091219303678-main.pdf

accesso aperto

1.88 MB Adobe PDF Visualizza/Apri
1-s2.0-S0007091219303678-main.pdf

accesso aperto

1.82 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/853097
Citazioni
  • ???jsp.display-item.citation.pmc??? 18
  • Scopus 29
  • ???jsp.display-item.citation.isi??? 27
social impact