What is it about?
Mechanical ventilation has come to a complete revolution in the last decades. Lately, new information is coming from real-time images generated at the bed-side, through electrical impedance tomography (EIT). In children, for the first time, EIT depicted pendelluft, a recently described phenomenon that might damage the lungs, even when considered protective ventilatory settings are being applied.
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Why is it important?
Respiratory support to infants in the ICU is frequently performed maintaining spontaneous breathing, aiming the avoidance of excessive sedation and respiratory muscles weakness. Strong diaphragm contractions acting over collapsed lungs, however, might be harmful due to pendelluft and its effect on increasing local tidal ventilation. This potentially harmful mechanism was not previously described in young patients, and need to be kept in mind while defining respiratory parameters and strategies at the bedside.
Perspectives
Electrical impedance tomography (EIT) application at the bedside is leading the surge of many new informations and concerns, and they must be taken into account when planning respiratory support to more severe patients. Maintaining spontaneous respirations at any cost, a frequent idea while treating young infants and even preterm infants, should be reassessed as new information comes from EIT studies.
FELIPE ROSSI
Hospital Israelita Albert Einstein
Read the Original
This page is a summary of: Pendelluft Detection Using Electrical Impedance Tomography in an Infant. Keep Those Images in Mind, American Journal of Respiratory and Critical Care Medicine, December 2019, American Thoracic Society,
DOI: 10.1164/rccm.201902-0461im.
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