Assessment of Changes in Distribution of Lung Perfusion by Electrical Impedance Tomography

Publisher： Karger

E-ISSN： 1423-0356|77|3|282-291

ISSN： 0025-7931

Source： Respiration, Vol.77, Iss.3, 2009-01, pp. : 282-291

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Abstract

Background: Electrical impedance tomography (EIT) is able to detect variations in regional lung electrical impedance associated with changes in both air and blood content and potentially capable of assessing regional ventilation-perfusion relationships. However, regional lung perfusion is difficult to determine because the impedance changes synchronous with the heart rate are of very small amplitude. Objectives: The aim of our study was to determine the redistribution of lung perfusion elicited by one-lung ventilation using EIT with a novel region-of-interest analysis. Methods: Ten patients (65 ± 9 years, mean age ± SD) scheduled for elective chest surgery were studied after intubation with a double-lumen endotracheal tube during bilateral and unilateral ventilation of the right and left lungs. EIT data were acquired at a rate of 25 scans/s. Relative impedance changes synchronous with the heart rate were evaluated in the right and left lung regions. Results: During bilateral ventilation, the mean right-to-left lung ratio of the sum of heart rate-related impedance changes was 1.12 ± 0.20, but the ratio significantly changed (0.81 ± 0.16 and 1.48 ± 0.37) during unilateral left- and right-lung ventilation with reduced perfusion of the non-ventilated lung. Increased perfusion most likely occurred in the ventilated lung because the impedance values summed over both regions did not change (0.62 ± 0.23 vs. 0.58 ± 0.22) compared with bilateral ventilation. Conclusions: Our results indicate that redistribution of regional lung perfusion can be assessed by EIT during one-lung ventilation. The performance of EIT in detecting changes in lung perfusion in even smaller lung regions remains to be established.