Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus

Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	He, Huaiwu [verfasserIn] Chi, Yi [verfasserIn] Long, Yun [verfasserIn] Yuan, Siyi [verfasserIn] Frerichs, Inéz [verfasserIn] Möller, Knut [verfasserIn] Fu, Feng [verfasserIn] Zhao, Zhanqi [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Electrical impedance tomography Shunt Dead space Ventilation–perfusion matching Overdistension Recruitment Ventilation distribution Lung perfusion

Übergeordnetes Werk:	Enthalten in: Critical care - London : BioMed Central, 1997, 24(2020), 1 vom: 29. Sept.
Übergeordnetes Werk:	volume:24 ; year:2020 ; number:1 ; day:29 ; month:09

Links:	Volltext

DOI / URN:	10.1186/s13054-020-03301-x

Katalog-ID:	SPR041138465

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245	1	0	\|a Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
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520			\|a Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered.
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allfields	10.1186/s13054-020-03301-x doi (DE-627)SPR041138465 (SPR)s13054-020-03301-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.00 bkl He, Huaiwu verfasserin aut Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered. Electrical impedance tomography (dpeaa)DE-He213 Shunt (dpeaa)DE-He213 Dead space (dpeaa)DE-He213 Ventilation–perfusion matching (dpeaa)DE-He213 Overdistension (dpeaa)DE-He213 Recruitment (dpeaa)DE-He213 Ventilation distribution (dpeaa)DE-He213 Lung perfusion (dpeaa)DE-He213 Chi, Yi verfasserin aut Long, Yun verfasserin aut Yuan, Siyi verfasserin aut Frerichs, Inéz verfasserin aut Möller, Knut verfasserin aut Fu, Feng verfasserin aut Zhao, Zhanqi verfasserin aut Enthalten in Critical care London : BioMed Central, 1997 24(2020), 1 vom: 29. Sept. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:24 year:2020 number:1 day:29 month:09 https://dx.doi.org/10.1186/s13054-020-03301-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 ASE AR 24 2020 1 29 09
spelling	10.1186/s13054-020-03301-x doi (DE-627)SPR041138465 (SPR)s13054-020-03301-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.00 bkl He, Huaiwu verfasserin aut Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered. Electrical impedance tomography (dpeaa)DE-He213 Shunt (dpeaa)DE-He213 Dead space (dpeaa)DE-He213 Ventilation–perfusion matching (dpeaa)DE-He213 Overdistension (dpeaa)DE-He213 Recruitment (dpeaa)DE-He213 Ventilation distribution (dpeaa)DE-He213 Lung perfusion (dpeaa)DE-He213 Chi, Yi verfasserin aut Long, Yun verfasserin aut Yuan, Siyi verfasserin aut Frerichs, Inéz verfasserin aut Möller, Knut verfasserin aut Fu, Feng verfasserin aut Zhao, Zhanqi verfasserin aut Enthalten in Critical care London : BioMed Central, 1997 24(2020), 1 vom: 29. Sept. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:24 year:2020 number:1 day:29 month:09 https://dx.doi.org/10.1186/s13054-020-03301-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 ASE AR 24 2020 1 29 09
allfields_unstemmed	10.1186/s13054-020-03301-x doi (DE-627)SPR041138465 (SPR)s13054-020-03301-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.00 bkl He, Huaiwu verfasserin aut Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered. Electrical impedance tomography (dpeaa)DE-He213 Shunt (dpeaa)DE-He213 Dead space (dpeaa)DE-He213 Ventilation–perfusion matching (dpeaa)DE-He213 Overdistension (dpeaa)DE-He213 Recruitment (dpeaa)DE-He213 Ventilation distribution (dpeaa)DE-He213 Lung perfusion (dpeaa)DE-He213 Chi, Yi verfasserin aut Long, Yun verfasserin aut Yuan, Siyi verfasserin aut Frerichs, Inéz verfasserin aut Möller, Knut verfasserin aut Fu, Feng verfasserin aut Zhao, Zhanqi verfasserin aut Enthalten in Critical care London : BioMed Central, 1997 24(2020), 1 vom: 29. Sept. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:24 year:2020 number:1 day:29 month:09 https://dx.doi.org/10.1186/s13054-020-03301-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 ASE AR 24 2020 1 29 09
allfieldsGer	10.1186/s13054-020-03301-x doi (DE-627)SPR041138465 (SPR)s13054-020-03301-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.00 bkl He, Huaiwu verfasserin aut Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered. Electrical impedance tomography (dpeaa)DE-He213 Shunt (dpeaa)DE-He213 Dead space (dpeaa)DE-He213 Ventilation–perfusion matching (dpeaa)DE-He213 Overdistension (dpeaa)DE-He213 Recruitment (dpeaa)DE-He213 Ventilation distribution (dpeaa)DE-He213 Lung perfusion (dpeaa)DE-He213 Chi, Yi verfasserin aut Long, Yun verfasserin aut Yuan, Siyi verfasserin aut Frerichs, Inéz verfasserin aut Möller, Knut verfasserin aut Fu, Feng verfasserin aut Zhao, Zhanqi verfasserin aut Enthalten in Critical care London : BioMed Central, 1997 24(2020), 1 vom: 29. Sept. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:24 year:2020 number:1 day:29 month:09 https://dx.doi.org/10.1186/s13054-020-03301-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 ASE AR 24 2020 1 29 09
allfieldsSound	10.1186/s13054-020-03301-x doi (DE-627)SPR041138465 (SPR)s13054-020-03301-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.00 bkl He, Huaiwu verfasserin aut Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered. Electrical impedance tomography (dpeaa)DE-He213 Shunt (dpeaa)DE-He213 Dead space (dpeaa)DE-He213 Ventilation–perfusion matching (dpeaa)DE-He213 Overdistension (dpeaa)DE-He213 Recruitment (dpeaa)DE-He213 Ventilation distribution (dpeaa)DE-He213 Lung perfusion (dpeaa)DE-He213 Chi, Yi verfasserin aut Long, Yun verfasserin aut Yuan, Siyi verfasserin aut Frerichs, Inéz verfasserin aut Möller, Knut verfasserin aut Fu, Feng verfasserin aut Zhao, Zhanqi verfasserin aut Enthalten in Critical care London : BioMed Central, 1997 24(2020), 1 vom: 29. Sept. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:24 year:2020 number:1 day:29 month:09 https://dx.doi.org/10.1186/s13054-020-03301-x kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.00 ASE AR 24 2020 1 29 09
language	English
source	Enthalten in Critical care 24(2020), 1 vom: 29. Sept. volume:24 year:2020 number:1 day:29 month:09
sourceStr	Enthalten in Critical care 24(2020), 1 vom: 29. Sept. volume:24 year:2020 number:1 day:29 month:09
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Electrical impedance tomography Shunt Dead space Ventilation–perfusion matching Overdistension Recruitment Ventilation distribution Lung perfusion
dewey-raw	610
isfreeaccess_bool	true
container_title	Critical care
authorswithroles_txt_mv	He, Huaiwu @@aut@@ Chi, Yi @@aut@@ Long, Yun @@aut@@ Yuan, Siyi @@aut@@ Frerichs, Inéz @@aut@@ Möller, Knut @@aut@@ Fu, Feng @@aut@@ Zhao, Zhanqi @@aut@@
publishDateDaySort_date	2020-09-29T00:00:00Z
hierarchy_top_id	331258269
dewey-sort	3610
id	SPR041138465
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR041138465</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519092031.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2020 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s13054-020-03301-x</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR041138465</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s13054-020-03301-x-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">ASE</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.00</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">He, Huaiwu</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. 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author	He, Huaiwu
spellingShingle	He, Huaiwu ddc 610 bkl 44.00 misc Electrical impedance tomography misc Shunt misc Dead space misc Ventilation–perfusion matching misc Overdistension misc Recruitment misc Ventilation distribution misc Lung perfusion Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
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topic_title	610 ASE 44.00 bkl Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus Electrical impedance tomography (dpeaa)DE-He213 Shunt (dpeaa)DE-He213 Dead space (dpeaa)DE-He213 Ventilation–perfusion matching (dpeaa)DE-He213 Overdistension (dpeaa)DE-He213 Recruitment (dpeaa)DE-He213 Ventilation distribution (dpeaa)DE-He213 Lung perfusion (dpeaa)DE-He213
topic	ddc 610 bkl 44.00 misc Electrical impedance tomography misc Shunt misc Dead space misc Ventilation–perfusion matching misc Overdistension misc Recruitment misc Ventilation distribution misc Lung perfusion
topic_unstemmed	ddc 610 bkl 44.00 misc Electrical impedance tomography misc Shunt misc Dead space misc Ventilation–perfusion matching misc Overdistension misc Recruitment misc Ventilation distribution misc Lung perfusion
topic_browse	ddc 610 bkl 44.00 misc Electrical impedance tomography misc Shunt misc Dead space misc Ventilation–perfusion matching misc Overdistension misc Recruitment misc Ventilation distribution misc Lung perfusion
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title	Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
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title_full	Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
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author_browse	He, Huaiwu Chi, Yi Long, Yun Yuan, Siyi Frerichs, Inéz Möller, Knut Fu, Feng Zhao, Zhanqi
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title_sort	influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
title_auth	Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
abstract	Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered.
abstractGer	Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered.
abstract_unstemmed	Background High positive end-expiratory pressures (PEEP) may induce overdistension/recruitment and affect ventilation–perfusion matching (VQMatch) in mechanically ventilated patients. This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. Registered on 9 September 2019—retrospectively registered.
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title_short	Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus
url	https://dx.doi.org/10.1186/s13054-020-03301-x
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up_date	2024-07-03T20:27:38.591Z
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This study aimed to investigate the association between PEEP-induced lung overdistension/recruitment and VQMatch by electrical impedance tomography (EIT). Methods The study was conducted prospectively on 30 adult mechanically ventilated patients: 18/30 with ARDS and 12/30 with high risk for ARDS. EIT measurements were performed at zero end-expiratory pressures (ZEEP) and subsequently at high (12–15 $ cmH_{2} $O) PEEP. The number of overdistended pixels over the number of recruited pixels (O/R ratio) was calculated, and the patients were divided into low O/R (O/R ratio < 15%) and high O/R groups (O/R ratio ≥ 15%). The global inhomogeneity (GI) index was calculated to evaluate the ventilation distribution. Lung perfusion image was calculated from the EIT impedance–time curves caused by 10 ml 10% NaCl injection during a respiratory pause (> 8 s). $ DeadSpace_{%} $, $ Shunt_{%} $, and $ VQMatch_{%} $ were calculated based on lung EIT perfusion and ventilation images. Results Increasing PEEP resulted in recruitment mainly in dorsal regions and overdistension mainly in ventral regions. $ ΔVQMatch_{%} $ ($ VQMatch_{%} $ at high PEEP minus that at ZEEP) was significantly correlated with recruited pixels (r = 0.468, P = 0.009), overdistended pixels (r = − 0.666, P < 0.001), O/R ratio (r = − 0.686, P < 0.001), and $ ΔSpO_{2} $ (r = 0.440, P = 0.015). Patients in the low O/R ratio group (14/30) had significantly higher $ Shunt_{%} $ and lower $ VQMatch_{%} $ than those in the high O/R ratio group (16/30) at ZEEP but not at high PEEP. Comparable $ DeadSpace_{%} $ was found in both groups. A high PEEP caused a significant improvement of $ VQMatch_{%} $, $ DeadSpace_{%} $, $ Shunt_{%} $, and GI in the low O/R ratio group, but not in the high O/R ratio group. Using O/R ratio of 15% resulted in a sensitivity of 81% and a specificity of 100% for an increase of $ VQMatch_{%} $ > 20% in response to high PEEP. Conclusions Change of ventilation–perfusion matching was associated with regional overdistention and recruitment induced by PEEP. A low O/R ratio induced by high PEEP might indicate a more homogeneous ventilation and improvement of VQMatch. Trial registration ClinicalTrials.gov, NCT04081155. 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Influence of overdistension/recruitment induced by high positive end-expiratory pressure on ventilation–perfusion matching assessed by electrical impedance tomography with saline bolus

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