电阻抗断层成像指导机械通气呼吸末正压设置的研究进展

Research progress on electrical impedance tomography guiding positive end-expiratory pressure setting during mechanical ventilation

目前机械通气设置最佳呼气末正压(PEEP)的策略仍需要进一步临床探索,电阻抗断层成像(EIT)是20世纪末新发展的临床技术,能够实时监测肺通气等,有助于临床应用来探索最佳PEEP的设置。本综述重点总结了近几年发表的使用EIT指导PEEP设定的原理,通过监测呼吸系统顺应性、空间分布、时间分布、局部肺灌注等信息设定PEEP,以及分析了用此方法设定PEEP的效果和/或使用EIT进行个体化PEEP设置的相关基础与临床研究信息。

At present,the strategy of setting the optimal positive end-expiratory pressure(PEEP)for mechanical ventilation still needs further clinical exploration.Electrical impedance tomography(EIT)is a newly developed technology at the end of the 20th century.It can monitor pulmonary ventilation in real time,so is extensively important to optimal PEEP setting.This review summarizes the principles of using EIT to guide PEEP setting,monitoring respiratory system compliance,spatial distribution,temporal distribution,local lung perfusion and other information published in recent years,analyzes the basic and clinical research information related to PEEP effect and its application in individualized PEEP setting.