Continuous noninvasive monitoring of lung recruitment during high-frequency oscillatory ventilation by electrical impedance measurement: An animal study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Wolfram Burkhardt - , TUD Dresden University of Technology (Author)
  • Florian Kurth - , TUD Dresden University of Technology, Charité – Universitätsmedizin Berlin (Author)
  • Manuela Pitterle - , Innsbruck Medical University (Author)
  • Nicola Blassnig - , TUD Dresden University of Technology (Author)
  • Andreas Wemhöner - , TUD Dresden University of Technology (Author)
  • Mario Rüdiger - , Department of Paediatrics, Center for feto/neonatal Health (Author)

Abstract

Background: Ventilatory pressures should target the range between the upper and lower inflection point of the pressure volume curve in order to avoid atelecto- and volutrauma. During high-frequency oscillatory ventilation (HFOV), this range is difficult to determine. Quadrant impedance measurement (QIM) has recently been shown to allow accurate and precise measurement of lung volume changes during conventional mechanical ventilation. Objectives: To investigate if QIM can be used to determine a static pressure-residual impedance curve during a recruitment-derecruitment manoeuvre on HFOV and to monitor the time course of alveolar recruitment after changing mean airway pressure (MAP). Methods: An incremental and decremental MAP trial (6 cm H2O to 27 cm H2O) was conducted in five surfactant-depleted newborn piglets during HFOV. Ventilatory, gas exchange and haemodynamic parameters were recorded. Continuous measurement of thoracic impedance change was performed. Results: Mean residual impedance (RI) increased with each stepwise increase of MAP resulting in a total mean increase of +26.5% (±4.0) at the highest MAP (27 cm H2O) compared to baseline ventilation at 6 cm H2O. Upon decreasing MAP levels, RI fell more slowly compared to its ascent; 83.4% (±19.1) and 84.8% (±16.4) of impedance changes occurred in the first 5 min after an increase or decrease in airway pressure, respectively. Conclusions: QIM could be used for continuous monitoring of thoracic impedance and determination of the pressure-RI curve during HFOV. The method could prove to be a promising bedside method for the monitoring of lung recruitment during HFOV in the future.

Details

Original languageEnglish
Pages (from-to)218-223
Number of pages6
Journal Neonatology : fetal and neonatal research
Volume103
Issue number3
Publication statusPublished - Mar 2013
Peer-reviewedYes

External IDs

Scopus 84876152217
PubMed 23364000

Keywords

Keywords

  • High-frequency oscillatory ventilation, Quadrant impedance measurement, Residual impedance