RT Journal Article
SR Electronic
T1 Electrical impedance tomography monitoring for predicting lung collapse after positive end expiratory pressure decrement in recovering acute respiratory distress syndrome
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA4023
DO 10.1183/13993003.congress-2021.OA4023
VO 58
IS suppl 65
A1 thunyawee sermkaew
A1 Napplika Kongpolprom
YR 2021
UL http://erj.ersjournals.com/content/58/suppl_65/OA4023.abstract
AB Background: PEEP decrement in recovering ARDS patients may cause alveolar derecruitment. The study aimed to evaluate EIT-parameters that could predict lung collapse from PEEP reduction.Methods: We conducted a prospective study. The eligible criteria were recovering ARDS patients with PF ratio ≥ 150 mmHg and PEEP ≥ 8 cmH2O. We measured lung mechanics and EELV by EIT and a nitrogen washin-washout technique at baseline, 5, 30 and 120 minutes after 2-cmH2O PEEP reduction. Lung collapse, defined as the decreased SpO2 by ≥ 3% or PaO2 by ≥10%, was observed. The primary outcome was EIT parameters for lung collapse. The secondary outcome was the correlation of EELV measured by 2 techniques.Results: Totally, 27 procedures were performed in 12 patients. There were 14(51.8%) lung collapse events occurring. The change of global EELI measured by EIT at 5th minute after PEEP reduction was not associated with lung collapse while the changes of EELV at 5th and 30th minutes were associated with lung collapse. At cut-off levels of EELV decrease by 10% and 7% at 5th and 30th minutes, the odd ratios for lung collapse were 12 and 7.5, respectively. There was no correlation of EELV between 2 techniques. Moreover, post hoc analysis found presence of EELI slope decline at dorsal part of lung at 5 minutes was the best predictor for lung collapse with the odd ratio of 20.Conclusions: Using EIT monitoring during PEEP reduction procedure in recovering ARDS, the changes of global EELI could not predict lung collapse and had no correlation to EELV changes. The presence of EELI slope decline at dorsal part of lung well predicted lung collapse.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA4023.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).