Non-invasive Imaging of the Neonatal Lung Using Electrical Impedance Tomography: A Narrative Review.

Abstract

Electrical impedance tomography (EIT) is a radiation-free, noninvasive method to measure the regional behavior of the lung which may be particularly suited to neonatal medicine. It is used more and more commonly in neonatology, particularly in the research setting. In order to harmonize efforts in terms of scientific and clinical use of this novel technology, we summarize the current knowledge on EIT use in both term and preterm infants and delineate potential future perspectives in this state-of-the-art article. We describe the current use in research and practice in neonatal medicine, including the following areas: (1) the cardiopulmonary transition immediately after birth, (2) changes in airway management including the use of different interfaces, endotracheal intubation, extubation to non-invasive respiratory support and (endotracheal) suctioning, (3) surfactant administration, (4) different body positions, (5) different modes of invasive and non-invasive respiratory support, (6) evaluation of acute pulmonary pathologies, (7) the predictive value of using EIT in neonatology, and (8) the assessment of pulmonary perfusion. In summary, EIT is a very valuable research tool in neonatal medicine where it allows us to understand physiological principles and pathogenesis of disease more deeply. It may also be useful for selected clinical situations in neonatology including major acute lung pathologies, as it allows accurate and non-invasive assessment of intrapulmonary volume changes in neonates. However, there are still some barriers to widespread implementation into clinical practice.