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Monitoring of Regional Lung Ventilation Using Electrical Impedance Tomography After Cardiac Surgery in Infants and Children

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Abstract

Electrical impedance tomography (EIT) is a noninvasive method to monitor regional lung ventilation in infants and children without using radiation. The objective of this prospective study was to determine the value of EIT as an additional monitoring tool to assess regional lung ventilation after pediatric cardiac surgery for congenital heart disease in infants and children. EIT monitoring was performed in a prospective study comprising 30 pediatric patients who were mechanically ventilated after cardiac surgery. Data were analyzed off-line with respect to regional lung ventilation in different clinical situations. EIT data were correlated with respirator settings and arterial carbon dioxide (CO2) partial pressure in the blood. In 29 of 30 patients, regional ventilation of the lung could sufficiently and reliably be monitored by means of EIT. The effects of the transition from mechanical ventilation to spontaneous breathing after extubation on regional lung ventilation were studied. After extubation, a significant decrease of relative impedance changes was evident. In addition, a negative correlation of arterial CO2 partial pressure and relative impedance changes could be shown. EIT was sufficient to discriminate differences of regional lung ventilation in children and adolescents after cardiac surgery. EIT reliably provided additional information on regional lung ventilation in children after cardiac surgery. Neither chest tubes nor pacemaker wires nor the intensive care unit environment interfered with the application of EIT. EIT therefore may be used as an additional real-time monitoring tool in pediatric cardiac intensive care because it is noninvasive.

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Authors and Affiliations

  1. Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center Göttingen, Georg-August-University Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany

    Ulrich Krause, Kristin Becker & Thomas Paul

  2. Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center Göttingen, Göttingen, Germany

    Günter Hahn & Jörg Dittmar

  3. Department of Thoracic and Cardiovascular Surgery, Congenital Cardiac Surgery, University Medical Center Göttingen, Göttingen, Germany

    Wolfgang Ruschewski

Authors
  1. Ulrich Krause
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  2. Kristin Becker
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  3. Günter Hahn
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  4. Jörg Dittmar
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  5. Wolfgang Ruschewski
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  6. Thomas Paul
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Correspondence to Ulrich Krause.

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Krause, U., Becker, K., Hahn, G. et al. Monitoring of Regional Lung Ventilation Using Electrical Impedance Tomography After Cardiac Surgery in Infants and Children. Pediatr Cardiol 35, 990–997 (2014). https://doi.org/10.1007/s00246-014-0886-6

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  • DOI: https://doi.org/10.1007/s00246-014-0886-6

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