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Comment
. 2024 Jun 15;209(12):1516-1518.
doi: 10.1164/rccm.202403-0573LE.

Electrical Impedance Tomography-based Ventilation Patterns for Evaluating Proper Ventilator Settings and to Classify Lung Morphofunction

Caio C A Morais  1   2 , Lorenzo Berra  3   4 , Elias Baedorf Kassis  5 , Rodrigo A Cornejo  6 , Shirley L Campos  1 , Daniella C Brandão  1 , Armèle Dornelas de Andrade  1 , Marcelo B P Amato  2 , Eduardo L V Costa  2   7
Affiliations
Comment

Electrical Impedance Tomography-based Ventilation Patterns for Evaluating Proper Ventilator Settings and to Classify Lung Morphofunction

Caio C A Morais et al. Am J Respir Crit Care Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
Classification of lung morphofunction. (A) Phenotypes of lung morphofunction according to the distribution of ventilation assessed by electrical impedance tomography (EIT) and (B) the change in the phenotype classification induced by different positive end-expiratory pressure (PEEP) levels. Overdistension is defined by a bilateral ventral hypoventilation (i.e., ventilation distribution <20% for ventral right and ventral left regions). Nonfocal phenotype is defined by a homogeneous ventilation distribution among lung quadrants (i.e., ventilation distribution ⩾20% for ventral right, ventral left, dorsal right, and dorsal left regions). Nonfocal phenotype is further divided into high compliance (bold H; >0.4 ml/cm H2O/kg) and low compliance (bold L; ⩽0.4 ml/cm H2O/kg) on the basis of respiratory system compliance. This combination of EIT pattern and respiratory system compliance can help assess the severity of nonfocal diseases, such as in patients with minimal or severe diffuse ground-glass opacities. The focal-unilateral phenotype is defined by reduced ventilation in only one of the dorsal quadrants (i.e., ventilation distribution <20% for dorsal right or dorsal left) or in a single lung (i.e., ventilation distribution <20% for ventral right and dorsal right or ventral left and dorsal left). The focal-bilateral phenotype consists of reduced ventilation bilaterally in the dorsal region (i.e., ventilation distribution <20% for dorsal right and dorsal left). The graph in (B) was produced using available data from previous studies on intubated patients with acute hypoxemic respiratory failure (PaO2/FiO2 < 300 mm Hg) assessed with EIT from four centers in three countries (Brazil, Chile, and the United States). All patients were monitored with EIT during a decremental PEEP trial in the supine position under pressure or volume-controlled modes without inspiratory effort. cm H2O = centimeters of water; D = dorsal; L = left; PBW = predicted body weight; R = right; V = ventral.
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