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դ�����Ԓ����S۬Q�*Z����k��x������. We read with great interest the study by Guillaume Franchineau et al. https://doi.org/10.1186/s13613-020-00719-y, DOI: https://doi.org/10.1186/s13613-020-00719-y. )���K��S�K�����!Ŷx�L�W̕�B},�\�^v��ȯ{��.� �܃�j�2�b�nz2���h���ٸ�B��+S�W��$! As pointed out by Franchineau et al., the reduction of PaCO2 and not the increase of PaO2 has been linked to the beneficial impact of prone positioning. J-MC reports personal fees and non-financial support from Drager, GE Healthcare, Sedana Medical, Baxter, and Amomed; personal fees from Fisher and Paykel Healthcare, Orion, Philips Medical, and Fresenius Medical Care; and non-financial support from LFB and Bird Corporation, outside of the submitted work. <> All authors read and approved the final manuscript. Ann Intensive Care. Jean-Michel Constantin. The “ROIs” section allows the evaluation of different regions of interest. The measurement of EIT, using the application of small alternating currents, determine the impedance changes related to ventilation in the thoracic section. EIT imaging maps that provide regional information regarding ventilation and perfusion of the lung. Privacy The FluxMed monitors also have the possibility of incorporating an Electrical Impedance Tomography (EIT) module. EIT may be more effective, first to assess collapsed and overdistended regions and determine ARDS morphology, but … Correspondence to 2018;37:251–8. [1], which assessed regional ventilation during prone positioning in acute respiratory distress syndrome (ARDS) patients treated with venovenous-extracorporeal membrane oxygenation (ECMO) using electrical impedance tomography (EIT). The measurement of EIT, using the application of small alternating currents, determine the impedance changes related to ventilation in the thoracic section. However, it does not allow to evaluate lung overdistension and only focuses on a restricted part of the subpleural lung parenchyma. 2013;17:243. But first of all, it is mandatory to define what pattern or measure obtained from EIT could be used to allow a clear distinction of focal and non-focal ARDS. Hence, lung morphology assessment seems to be a major issue. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. 5 0 obj Lancet Respir Med. Part of Rather than using EIT to monitor local compliance variation, EIT may be used to select prone position candidates with focal ARDS and to apply an optimal PEEP after a PEEP trial for non-focal patients. ����g��щ1|p�&��ЫZ�CG��\M)�}�k7]��>�O�W���^���=�Aj4��IF In this work, the authors found that patients with a compliance gain after prone positioning (defined as an increase in static respiratory system compliance of more than 3 mL/cmH2O) had a lower repartition of the tidal volume in the dorsal region of the lung at baseline. The results of Franchineau et al. Some authors argue that lung ultrasonography may be of interest [5]. statement and Santa Fé 1955 (B1640IFG) Thus, if prone positioning may benefit all ARDS patients, resulting in a more homogeneous distribution of aeration and reduced dead-space, its beneficial impact on survival is probably largely influenced by the predominance of the focal pattern among ARDS patients. Anaesth Crit Care Pain Med. Frerichs et al. Terms and Conditions, To conclude, we believe that EIT may be used to assess lung morphology and apply personalized ventilation strategy. Cardiologists and pulmonologists will use EIT to assess their patient’s heart and lung function, supplementing conventional information obtained by X-ray, lung function testing and ultrasound. It also allows the assessment of short-term changes in lung volume at the end of expiration through end-expiratory lung impedance (EELI) and "tidal" impedance (TZ). Prone positioning monitored by electrical impedance tomography in patients with severe acute respiratory distress syndrome on veno-venous ECMO. PubMed Google Scholar. @.K�ҩ��N��)���5t����N��Y��z�֊�9a&�p��E?Z�M)6m��Z�N�91DVci���(���f���~q�C��3�v1rN���֢�0%E�uN6�B�u͟�?�������zx�J�L6�c9 Ck�Tl}�nIC���UU������M�d�N'�, �q� �NBDžQ��f���ѡ���� զeW�Ǫm'Ɓle����u3�)���K`^�Rm�lE�ٷPW�Rs�s��y��p���Z�N�W�m`"������F��?��嗱ړR��l����Y�*�y�˷HBsD����,�~�z�ŠJa�d All other authors declare that they have no competing interests. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. �V�P��b^ouy��� >U�V´=q��za�RqSn�yc�I��v��b%E� >��~�LR�p)�q�\5��]�ݳ�k�+D�4D�1�VXƺj���[ٴ�p�L��(j!{YQ[Ơ! Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. California Privacy Statement, Composite Graph synchronized with the FluxMed signals, Non-invasive and does not apply ionizing radiation. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. EIT for private practices. performed measurements with the EIT system Mk1 and generated images of neonates with RDS after surfactant administration. EIT may be more effective, first to assess collapsed and overdistended regions and determine ARDS morphology, but also as a monitoring tool to assess response to therapies such as positive end expiratory pressure (PEEP) and prone positioning.
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