电阻抗断层成像技术在成年人急性呼吸窘迫综合征中的应用

Application of electrical impedance tomography in adults with acute respiratory distress syndrome

电阻抗断层成像(electrical impedance tomography,EIT)技术具备床旁、无创、无辐射、动态功能成像等特点,可评估整体及局部肺通气和灌注,监测肺内不同区域间的差异,进一步优化呼吸治疗,制定个体化方案.文章对EIT的监测原理,在肺通气、灌注监测时常用的参数,以及在成年人急性呼吸窘迫综合征患者中的应用,包括经鼻高流量氧疗、机械通气(呼气末正压滴定、肺复张、撤机)、俯卧位及静脉-静脉体外膜肺氧合进行综述,旨在为临床实践提供参考.

Electrical impedance tomography(EIT)has the advantages of being bedside,non-invasive,non-radiation,and dynamic functional imaging.It can assess global and regional lung ventilation and perfusion,and evaluate the differences between different regions in the lungs,in order to optimize respiratory therapy and formulate individualized management.This article reviews the principle of EIT monitoring,the parameters commonly used in monitoring lung ventilation and perfusion,and its application in adults with acute respiratory distress syndrome,including nasal high-flow oxygen therapy,mechanical ventilation(titration of positive end-expiratory pressure,lung recruitment maneuvers and withdrawal of ventilator supports),prone positioning,and veno-venous extracorporeal membrane oxygenation,in order to provide reference for clinical practice.