灌注
肺
医学
通风(建筑)
正电子发射断层摄影术
电阻抗断层成像
生理盐水
灌注扫描
核医学
通气灌注不匹配
断层摄影术
麻醉
内科学
放射科
物理
热力学
作者
Thomas Bluth,Thomas Kiss,Michael Kircher,Anja Braune,C. Bozsak,Robert Huhle,Martin Scharffenberg,Moritz Herzog,J. Roegner,P. Herzog,Luigi Vivona,Marco Millone,Olaf Dössel,Michael Andreeff,Thea Koch,Jörg Kotzerke,Birgit Stender,Marcelo Gama de Abreu
标识
DOI:10.1016/j.bja.2019.04.056
摘要
Electrical impedance tomography (EIT) with indicator dilution may be clinically useful to measure relative lung perfusion, but there is limited information on the performance of this technique.Thirteen pigs (50-66 kg) were anaesthetised and mechanically ventilated. Sequential changes in ventilation were made: (i) right-lung ventilation with left-lung collapse, (ii) two-lung ventilation with optimised PEEP, (iii) two-lung ventilation with zero PEEP after saline lung lavage, (iv) two-lung ventilation with maximum PEEP (20/25 cm H2O to achieve peak airway pressure 45 cm H2O), and (v) two-lung ventilation under unilateral pulmonary artery occlusion. Relative lung perfusion was assessed with EIT and central venous injection of saline 3%, 5%, and 10% (10 ml) during breath holds. Relative perfusion was determined by positron emission tomography (PET) using 68Gallium-labelled microspheres. EIT and PET were compared in eight regions of equal ventro-dorsal height (right, left, ventral, mid-ventral, mid-dorsal, and dorsal), and directional changes in regional perfusion were determined.Differences between methods were relatively small (95% of values differed by less than 8.7%, 8.9%, and 9.5% for saline 10%, 5%, and 3%, respectively). Compared with PET, EIT underestimated relative perfusion in dependent, and overestimated it in non-dependent, regions. EIT and PET detected the same direction of change in relative lung perfusion in 68.9-95.9% of measurements.The agreement between EIT and PET for measuring and tracking changes of relative lung perfusion was satisfactory for clinical purposes. Indicator-based EIT may prove useful for measuring pulmonary perfusion at bedside.
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