Comparing ventilation modes by electrical impedance segmentography in ventilated children.

Autor: Brandt JB; Division of Neonatology, Medical University of Vienna, Pediatric Intensive Care & Neuropediatrics, Vienna, Austria., Mahlknecht A; Hospital of the Brothers of St. John of God, Eisenstadt, Austria., Werther T; Division of Neonatology, Medical University of Vienna, Pediatric Intensive Care & Neuropediatrics, Vienna, Austria., Ullrich R; Department for Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria., Hermon M; Division of Neonatology, Medical University of Vienna, Pediatric Intensive Care & Neuropediatrics, Vienna, Austria. michael.hermon@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: Journal of clinical monitoring and computing [J Clin Monit Comput] 2022 Dec; Vol. 36 (6), pp. 1795-1803. Date of Electronic Publication: 2022 Feb 14.
DOI: 10.1007/s10877-022-00828-y
Abstrakt: Electrical impedance segmentography offers a new radiation-free possibility of continuous bedside ventilation monitoring. The aim of this study was to evaluate the efficacy and reproducibility of this bedside tool by comparing synchronized intermittent mandatory ventilation (SIMV) with neurally adjusted ventilatory assist (NAVA) in critically-ill children. In this prospective randomized case-control crossover trial in a pediatric intensive care unit of a tertiary center, including eight mechanically-ventilated children, four sequences of two different ventilation modes were consecutively applied. All children were randomized into two groups; starting on NAVA or SIMV. During ventilation, electric impedance segmentography measurements were recorded. The relative difference of vertical impedance between both ventilatory modes was measured (median 0.52, IQR 0-0.87). These differences in left apical lung segments were present during the first (median 0.58, IQR 0-0.89, p = 0.04) and second crossover (median 0.50, IQR 0-0.88, p = 0.05) as well as across total impedance (0.52 IQR 0-0.87; p = 0.002). During NAVA children showed a shift of impedance towards caudal lung segments, compared to SIMV. Electrical impedance segmentography enables dynamic monitoring of transthoracic impedance. The immediate benefit of personalized ventilatory strategies can be seen when using this simple-to-apply bedside tool for measuring lung impedance.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz: