Electrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility study

Página do item simplificado
dc.contributor.authorRossi, Felipe de Souza
dc.contributor.authorZanon Yagui, Ana Cristina
dc.contributor.authorHaddad, Luciana Branco
dc.contributor.authorDeutsch, Alice D'Agostini
dc.contributor.authorRebello, Celso Moura
dc.contributor.institutionHosp Israelita Albert Einstein
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:30:59Z
dc.date.available2016-01-24T14:30:59Z
dc.date.issued2013-01-01
dc.description.abstractOBJECTIVES: Nasal continuous positive airway pressure is used as a standard of care after extubation in very-low-birth-weight infants. A pressure of 5 cmH(2)O is usually applied regardless of individual differences in lung compliance. Current methods for evaluation of lung compliance and air distribution in the lungs are thus imprecise for preterm infants. This study used electrical impedance tomography to determine the feasibility of evaluating the positive end-expiratory pressure level associated with a more homogeneous air distribution within the lungs before extubation.METHODS: Ventilation homogeneity was defined by electrical impedance tomography as the ratio of ventilation between dependent and non-dependent lung areas. the best ventilation homogeneity was achieved when this ratio was equal to 1. Just before extubation, decremental expiratory pressure levels were applied (8, 7, 6 and 5 cmH(2)0; 3 minutes each step), and the pressure that determined the best ventilation homogeneity was defined as the best positive end-expiratory pressure.RESULTS: the best positive end-expiratory pressure value was 6.3 +/- 1.1 cmH(2)0, and the mean continuous positive airway pressure applied after extubation was 5.2 +/- 0.4 cmH(2)0 (p = 0.002). the extubation failure rate was 21.4%. X-Ray and blood gases after extubation were also checked.CONCLUSION: This study demonstrates that electrical impedance tomography can be safely and successfully used in patients ready for extubation to suggest the best ventilation homogeneity, which is influenced by the level of expiratory pressure applied. in this feasibility study, the best lung compliance was found with pressure levels higher than the continuous positive airway pressure levels that are usually applied for routine extubation.en
dc.description.affiliationHosp Israelita Albert Einstein, Dept Maternoinfantil, São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Fac Med, Dept Pediat, Hosp Clin,Inst Crianca,Disciplina Pediat Neonatal, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipExperimental Pneumology Laboratory - LIM 09, University of São Paulo
dc.format.extent345-350
dc.identifierhttp://dx.doi.org/10.6061/clinics/2013(03)OA10
dc.identifier.citationClinics. São Paulo: Hospital Clinicas, Univ São Paulo, v. 68, n. 3, p. 345-350, 2013.
dc.identifier.doi10.6061/clinics/2013(03)OA10
dc.identifier.fileS1807-59322013000300011.pdf
dc.identifier.issn1807-5932
dc.identifier.scieloS1807-59322013000300011
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/35763
dc.identifier.wosWOS:000320000800011
dc.language.isoeng
dc.publisherHospital Clinicas, Univ São Paulo
dc.relation.ispartofClinics
dc.rightsAcesso aberto
dc.subjectInfanten
dc.subjectPrematureen
dc.subjectElectric Impedanceen
dc.subjectContinuous Positive Airway Pressureen
dc.titleElectrical impedance tomography to evaluate air distribution prior to extubation in very-low-birth-weight infants: a feasibility studyen
dc.typeArtigo
Arquivos
Pacote Original
Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
S1807-59322013000300011.pdf
Tamanho:
2.92 MB
Formato:
Adobe Portable Document Format
Descrição:
Baixar
Coleções
Em verificação - Geral