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电阻抗断层成像技术用于呼气末正压滴定的研究进展
引用本文:马效禹,范得慧,王威威. 电阻抗断层成像技术用于呼气末正压滴定的研究进展[J]. 临床麻醉学杂志, 2024, 40(2): 185-189
作者姓名:马效禹  范得慧  王威威
作者单位:150000,哈尔滨医科大学附属第二医院麻醉科
摘    要:适当的呼气末正压(PEEP)是保护性肺通气策略的重要组成部分,PEEP可以保持肺泡开放,减少肺萎陷伤。尽管个体化PEEP已被越来越多的临床医师认可,但最佳的PEEP滴定方法尚存争议。电阻抗断层成像(EIT)是一种无创、无辐射的成像技术,可在床边实时动态评估肺功能,将肺通气过程中的阻抗变化以动态图像呈现,能够反映PEEP调整前后肺内通气及气体分布变化,因此,EIT可用于滴定个体化PEEP。本文简要概括EIT的基本原理及监测指标,阐述临床应用EIT指导下的PEEP(PEEPEIT)滴定方法,旨在加强对EIT的优点和局限性的理解,为优化个体化PEEP的设置提供参考。

关 键 词:呼气末正压;电阻抗断层成像;机械通气;急性呼吸窘迫综合征

Research progress of electrical impedance tomography in positive end-expiratory pressure titration
MA Xiaoyu,FAN Dehui,WANG Weiwei. Research progress of electrical impedance tomography in positive end-expiratory pressure titration[J]. The Journal of Clinical Anesthesiology, 2024, 40(2): 185-189
Authors:MA Xiaoyu  FAN Dehui  WANG Weiwei
Affiliation:Department of Anesthesiology, the Second Affiliated Hospital, Harbin Medical University, Harbin 150000, China
Abstract:Appropriate positive end-expiratory pressure (PEEP) level is an important component of protective lung ventilation strategy. PEEP can maintain the openness of alveoli and reduce lung collapse injury. Although individualized PEEP application has been increasingly recognized by clinical physicians, the optimal PEEP titration method is still controversial. Electrical impedance tomography (EIT) is a non-invasive and radiation-free imaging technique that can be used to dynamically assess lung function at the bedside. EIT presents changes in impedance during ventilation as dynamic images, which can reflect alterations in ventilation and gas distribution before and after PEEP adjustments. Therefore, EIT can be utilized to tailor individualized PEEP. This article provides a brief overview of the basic principles and monitoring parameters of EIT. It elucidates the PEEP titration method under the guidance of EIT in clinical applications (PEEPEIT), aiming at enhancing the understanding of the advantages and limitations of EIT and providing reference for the setting of individualized PEEP.
Keywords:Positive end-expiratory pressure   Electrical impedance tomography   Mechanical ventilation   Acute respiratory distress syndrome
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