RT Journal Article SR Electronic T1 PEEP titration with lung ultrasound and electrical impedance tomography in an ARDS animal model JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P4892 VO 44 IS Suppl 58 A1 Elena Prina A1 Eduardo Leite Vieira Costa A1 Otávio Tavares Ranzani A1 Susimeire Gomes A1 Roberta Ribeiro De Santis Santiago A1 Myiuki Nakamura A1 Marcelo Britto Passos Amato A1 Antoni Torres A1 Carlos Roberto Ribeiro de Carvalho YR 2014 UL http://erj.ersjournals.com/content/44/Suppl_58/P4892.abstract AB Background:In ARDS, the identification of PEEP that confers the best compromise between lung collapse and hyperdistension remains a challenge. Electrical impedance tomography (EIT) quantifies recruitable collapse and hyperdistension. Lung ultrasound (LUS) detects PEEP-induced recruitment. Aims: to compare the collapse estimated with EIT and LUS during PEEP titration in an ARDS animal model; to compare the PEEP chosen based on EIT (PEEPEIT) and on LUS (PEEPUS).Methods: we evaluated 7 mechanically ventilated pigs with ARDS induced by saline-lavage and injurious ventilation. After recruitment, we titrated the PEEP while collecting data with EIT and performing LUS of the worst lung area. We defined a LUS score: 0-normal, 1-separated B lines, 2-confluent B lines, 3-subpleural consolidation, 4-partial and 5-extensive consolidation. PEEPEIT was defined as the lowest PEEP with EIT collapse≤1% and PEEPUS as the lowest PEEP with LUS score<4.Results: LUS patterns 4/5 had 100% sensitivity, 65% specificity to detect EIT collapse>1%(fig a). In two animals, LUS detected fixed collapse, which cannot be detected by EIT. PEEPUS was highly correlated with PEEPEIT, although higher (fig b,c) and with a trend to more hyperdistension (31±16% vs 19±8 p=0.15)Conclusions: LUS patterns had a good correlation with collapse estimated by EIT.The methods seem to be complementary since LUS detected fixed collapse, while EIT detected hyperdistension.