Identifying optimal positive end-expiratory pressure with electrical impedance tomography guidance in severe bronchopulmonary dysplasia.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-09-30 DOI:10.1038/s41372-025-02433-8

Jessica E Shui, Carolyn J LaVita, Glasiele C Alcala, John H Nichols, Romal K Jassar, Rodica M Turcu, Paul H Lerou, Maurizio F Cereda, Ryan W Carroll, Roberta Ribeiro De Santis Santiago, Lorenzo Berra

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引用次数: 0

Abstract

Objective: To assess the feasibility of electrical impedance tomography (EIT) guided positive end-expiratory pressure (PEEP) titration to identify optimal PEEP in infants with severe bronchopulmonary dysplasia (BPD).

Study design: Case series of five EIT guided PEEP titrations in infants with severe BPD compared to a case series of five infants, without lung disease, requiring intubation. Optimal PEEP was identified as minimal percentage of lung overdistension and collapse. Lung function, bedside ventilatory and clinical data were tracked post EIT guided optimal PEEP titration.

Result: Four out of the five EIT assessments in infants with BPD identified an optimal PEEP that was sustained for at least three weeks. Three of the four successful assessments led to a decrease in PEEP, compared to baseline, and one confirmed the baseline PEEP was optimal.

Conclusion: EIT assessments can be a novel tool to aide identification of optimal PEEP in infants with heterogeneous lung disease.

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用电阻抗断层扫描识别严重支气管肺发育不良患者的最佳呼气末正压。

目的：探讨电阻抗断层扫描（EIT）引导下呼气末正压（PEEP）滴定在重度支气管肺发育不良（BPD）患儿中确定最佳PEEP的可行性。研究设计：5例EIT引导下的严重BPD婴儿PEEP滴定与5例无肺部疾病且需要插管的婴儿进行比较。最佳PEEP被确定为肺过度扩张和塌陷的最小百分比。在EIT引导下进行最佳PEEP滴定后，跟踪肺功能、床边通气和临床数据。结果：在BPD婴儿的5个EIT评估中，有4个确定了持续至少3周的最佳PEEP。与基线相比，四次成功评估中有三次导致PEEP下降，一次证实基线PEEP是最佳的。结论：EIT评估可作为一种新的工具，帮助鉴别异质性肺疾病患儿的最佳PEEP。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.