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Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
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Related Experiment Video

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Comparing ventilation modes by electrical impedance segmentography in ventilated children.

Jennifer Bettina Brandt1, Alex Mahlknecht2, Tobias Werther1

  • 1Division of Neonatology, Medical University of Vienna, Pediatric Intensive Care & Neuropediatrics, Vienna, Austria.

Journal of Clinical Monitoring and Computing
|February 15, 2022
PubMed
Summary

Electrical impedance segmentography provides radiation-free ventilation monitoring in children. This tool effectively differentiates between synchronized intermittent mandatory ventilation (SIMV) and neurally adjusted ventilatory assist (NAVA), aiding personalized respiratory support.

Keywords:
Bedside monitoringDependent lung areaElectrical Impedance SegmentographyNAVAPediatric ventilationPersonalized ventilation

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Area of Science:

  • Critical care medicine
  • Pediatric respiratory physiology
  • Biomedical engineering

Background:

  • Continuous ventilation monitoring is crucial for critically-ill children.
  • Electrical impedance segmentography (EIS) offers a non-invasive, radiation-free alternative.
  • Comparing EIS efficacy between different ventilation modes is needed.

Purpose of the Study:

  • To evaluate the efficacy and reproducibility of EIS for monitoring ventilation in pediatric patients.
  • To compare EIS measurements during synchronized intermittent mandatory ventilation (SIMV) and neurally adjusted ventilatory assist (NAVA).

Main Methods:

  • Prospective randomized crossover trial involving 8 mechanically ventilated children.
  • Consecutive application of two ventilation modes: SIMV and NAVA.
  • Recording of electrical impedance segmentography measurements throughout ventilation.

Main Results:

  • Significant differences in vertical impedance were observed between SIMV and NAVA (median 0.52, IQR 0-0.87, p=0.002).
  • Left apical lung segments showed distinct impedance differences during both crossover periods (p=0.04 and p=0.05).
  • NAVA demonstrated a shift in impedance towards caudal lung segments compared to SIMV.

Conclusions:

  • Electrical impedance segmentography is a viable bedside tool for dynamic transthoracic impedance monitoring.
  • EIS can visualize immediate benefits of personalized ventilatory strategies.
  • This technology aids in optimizing respiratory support for critically-ill children.