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Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation

BACKGROUND: This study hypothesized that patients with extubation failure exhibit a loss of lung aeration and heterogeneity in air distribution, which could be monitored by chest EIT and lung ultrasound. Patients at risk of extubation failure were included after a successful spontaneous breathing tr...

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Autores principales: Joussellin, Vincent, Bonny, Vincent, Spadaro, Savino, Clerc, Sébastien, Parfait, Mélodie, Ferioli, Martina, Sieye, Antonin, Jalil, Yorschua, Janiak, Vincent, Pinna, Andrea, Dres, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522557/
https://www.ncbi.nlm.nih.gov/pubmed/37752365
http://dx.doi.org/10.1186/s13613-023-01180-3
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author Joussellin, Vincent
Bonny, Vincent
Spadaro, Savino
Clerc, Sébastien
Parfait, Mélodie
Ferioli, Martina
Sieye, Antonin
Jalil, Yorschua
Janiak, Vincent
Pinna, Andrea
Dres, Martin
author_facet Joussellin, Vincent
Bonny, Vincent
Spadaro, Savino
Clerc, Sébastien
Parfait, Mélodie
Ferioli, Martina
Sieye, Antonin
Jalil, Yorschua
Janiak, Vincent
Pinna, Andrea
Dres, Martin
author_sort Joussellin, Vincent
collection PubMed
description BACKGROUND: This study hypothesized that patients with extubation failure exhibit a loss of lung aeration and heterogeneity in air distribution, which could be monitored by chest EIT and lung ultrasound. Patients at risk of extubation failure were included after a successful spontaneous breathing trial. Lung ultrasound [with calculation of lung ultrasound score (LUS)] and chest EIT [with calculation of the global inhomogeneity index, frontback center of ventilation (CoV), regional ventilation delay (RVD) and surface available for ventilation] were performed before extubation during pressure support ventilation (H0) and two hours after extubation during spontaneous breathing (H2). EIT was then repeated 6 h (H6) after extubation. EIT derived indices and LUS were compared between patients successfully extubated and patients with extubation failure. RESULTS: 40 patients were included, of whom 12 (30%) failed extubation. Before extubation, when compared with patients with successful extubation, patients who failed extubation had a higher LUS (19 vs 10, p = 0.003) and a smaller surface available for ventilation (352 vs 406 pixels, p = 0.042). After extubation, GI index and LUS were higher in the extubation failure group, whereas the surface available for ventilation was lower. The RVD and the CoV were not different between groups. CONCLUSION: Before extubation, a loss of lung aeration was observed in patients who developed extubation failure afterwards. After extubation, this loss of lung aeration persisted and was associated with regional lung ventilation heterogeneity. Trial registration Clinical trials, NCT04180410, Registered 27 November 2019—prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04180410. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13613-023-01180-3.
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spelling pubmed-105225572023-09-28 Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation Joussellin, Vincent Bonny, Vincent Spadaro, Savino Clerc, Sébastien Parfait, Mélodie Ferioli, Martina Sieye, Antonin Jalil, Yorschua Janiak, Vincent Pinna, Andrea Dres, Martin Ann Intensive Care Research BACKGROUND: This study hypothesized that patients with extubation failure exhibit a loss of lung aeration and heterogeneity in air distribution, which could be monitored by chest EIT and lung ultrasound. Patients at risk of extubation failure were included after a successful spontaneous breathing trial. Lung ultrasound [with calculation of lung ultrasound score (LUS)] and chest EIT [with calculation of the global inhomogeneity index, frontback center of ventilation (CoV), regional ventilation delay (RVD) and surface available for ventilation] were performed before extubation during pressure support ventilation (H0) and two hours after extubation during spontaneous breathing (H2). EIT was then repeated 6 h (H6) after extubation. EIT derived indices and LUS were compared between patients successfully extubated and patients with extubation failure. RESULTS: 40 patients were included, of whom 12 (30%) failed extubation. Before extubation, when compared with patients with successful extubation, patients who failed extubation had a higher LUS (19 vs 10, p = 0.003) and a smaller surface available for ventilation (352 vs 406 pixels, p = 0.042). After extubation, GI index and LUS were higher in the extubation failure group, whereas the surface available for ventilation was lower. The RVD and the CoV were not different between groups. CONCLUSION: Before extubation, a loss of lung aeration was observed in patients who developed extubation failure afterwards. After extubation, this loss of lung aeration persisted and was associated with regional lung ventilation heterogeneity. Trial registration Clinical trials, NCT04180410, Registered 27 November 2019—prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04180410. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13613-023-01180-3. Springer International Publishing 2023-09-26 /pmc/articles/PMC10522557/ /pubmed/37752365 http://dx.doi.org/10.1186/s13613-023-01180-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. 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. 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. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Joussellin, Vincent
Bonny, Vincent
Spadaro, Savino
Clerc, Sébastien
Parfait, Mélodie
Ferioli, Martina
Sieye, Antonin
Jalil, Yorschua
Janiak, Vincent
Pinna, Andrea
Dres, Martin
Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
title Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
title_full Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
title_fullStr Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
title_full_unstemmed Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
title_short Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
title_sort lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522557/
https://www.ncbi.nlm.nih.gov/pubmed/37752365
http://dx.doi.org/10.1186/s13613-023-01180-3
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