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Effects of pleural effusion drainage in the mechanically ventilated patient as monitored by electrical impedance tomography and end-expiratory lung volume: A pilot study
A. Rara, K. Roubik, T. Tyll
Language English Country United States
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
NLK
ProQuest Central
from 2003-03-01 to 2 months ago
Nursing & Allied Health Database (ProQuest)
from 2003-03-01 to 2 months ago
Health & Medicine (ProQuest)
from 2003-03-01 to 2 months ago
- MeSH
- Tidal Volume MeSH
- Adult MeSH
- Drainage methods MeSH
- Electric Impedance * MeSH
- Intensive Care Units MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospitals, University MeSH
- Pilot Projects MeSH
- Pleural Effusion therapy MeSH
- Lung physiology MeSH
- Tomography, X-Ray Computed methods MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Positive-Pressure Respiration methods MeSH
- Hospitals, Military MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
PURPOSE: In patients with pleural effusion (PLE) monitored by Electrical Impedance Tomography (EIT) an increase in end-expiratory lung impedance (EELI) is observed following evacuation of the PLE. We aimed at differentiating the effect of fluid removal from lung reaeration and describe the change in ventilation distribution. MATERIALS AND METHODS: Mechanically ventilated patients were monitored by EIT during PLE evacuation. End-expiratory lung volume (EELV) was measured concurrently. We included a calibration maneuver consisting of an increase in positive end-expiratory pressure (PEEP) by 5 cm H2O. The ratio ΔEELI/ΔEELV was used to compare changes of EELI and EELV in response to the calibration maneuver and PLE evacuation. At the same time we assessed distribution of ventilation using changes in tidal variation. RESULTS: PLE removal resulted in a 6-fold greater increase in ΔEELI/ΔEELV when compared to the calibration maneuver (r = 0.84, p < .05). We observed a relative increase in ventilation in the area of the effusion (mean 7.1%, p < .006) and an overall shift of ventilation to the dorsal fraction of the lungs (mean 8%, p < .0002). CONCLUSIONS: The increase in EELI in the EIT image after PLE removal was primarily due to the removal of the conductive effusion fluid.
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- $a Rara, Ales $u Department of Anaesthesia and Intensive Care, Military University Hospital Prague, Czech Republic; Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Czech Republic. Electronic address: raraales@uvn.cz
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- $a PURPOSE: In patients with pleural effusion (PLE) monitored by Electrical Impedance Tomography (EIT) an increase in end-expiratory lung impedance (EELI) is observed following evacuation of the PLE. We aimed at differentiating the effect of fluid removal from lung reaeration and describe the change in ventilation distribution. MATERIALS AND METHODS: Mechanically ventilated patients were monitored by EIT during PLE evacuation. End-expiratory lung volume (EELV) was measured concurrently. We included a calibration maneuver consisting of an increase in positive end-expiratory pressure (PEEP) by 5 cm H2O. The ratio ΔEELI/ΔEELV was used to compare changes of EELI and EELV in response to the calibration maneuver and PLE evacuation. At the same time we assessed distribution of ventilation using changes in tidal variation. RESULTS: PLE removal resulted in a 6-fold greater increase in ΔEELI/ΔEELV when compared to the calibration maneuver (r = 0.84, p < .05). We observed a relative increase in ventilation in the area of the effusion (mean 7.1%, p < .006) and an overall shift of ventilation to the dorsal fraction of the lungs (mean 8%, p < .0002). CONCLUSIONS: The increase in EELI in the EIT image after PLE removal was primarily due to the removal of the conductive effusion fluid.
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