Automated Analysis of EIT Data for PEEP Setting

Maastricht University Medical Centre (MUMC)

Status: Completed

Conditions: Acute Hypoxemic Respiratory Failure; Post-cardiac Surgery

Treatments: Other: computerized algorithm for automated analysis

Study type: Observational

Funder types: Other

Identifiers

NCT03653806

17-4-053

Details and patient eligibility

About

First: to develop a computerized algorithm for automated analysis of the electrical impedance tomography (EIT) data. The algorithm calculates the "optimal" positive end-expiratory pressure (PEEP) and inspiratory pressure defined as the "optimal" balance between stretch, ventilation distribution and collapse.

Second: to compare the results of the algorithm with the current standard of care clinical judgement of an experienced ventilation practitioner.

Full description

The study will be performed at the Intensive Care Unit, Maastricht University Medical Centre. The investigators routinely apply EIT (Pulmovista, Dräger, Lübeck. Germany) in mechanically ventilated patients to optimize the ventilator settings .

An algorithm will be developed by the Institute of Technical Medicine, Furtwangen University, Germany. The algorithm will automatically detect changes in both PEEP and inspiratory pressures. For each PEEP step and/or changes in inspiratory pressure the difference in regional alveolar overdistension and alveolar collapse will be calculated. This makes it possible to select the optimal ventilator setting depending on the best compromise between alveolar overdistension and alveolar collapse.

The algorithm will be tested in 40 EIT guided mechanically ventilated patients. EIT measurements will be performed during an incremental and decremental PEEP trial. The EIT measurement will be performed in the same way as during standard clinical care. EIT data will be analysed offline by a ventilation practitioner with experience in EIT and with the newly developed algorithm. The resulting advice on optimal ventilator settings will be compared for inter-observer variability.

Enrollment: 40 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Mechanically ventilated in a volume or pressure controlled mode
• ventilator settings guided by EIT

Exclusion criteria

• Participants who specifically opt-out regarding the use of the data for research purpose
• Internal pacemaker, Implantable Cardioverter Defibrillator
• Skin lesions, dressings at the thorax, hindering belt placement
• Thoracic circumference < 70 cm
• Thoracic circumference > 150 cm
• BMI > 50