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Redistribution of pulmonary ventilation after lung surgery detected with electrical impedance tomography

Please always quote using this URN: urn:nbn:de:bvb:20-opus-213575
  • Background: Regional ventilation of the lung can be visualized by pulmonary electrical impedance tomography (EIT). The aim of this study was to examine the post‐operative redistribution of regional ventilation after lung surgery dependent on the side of surgery and its association with forced vital capacity. Methods: In this prospective, observational cohort study 13 patients undergoing right and 13 patients undergoing left‐sided open or video‐thoracoscopic procedures have been investigated. Pre‐operative measurements with EIT andBackground: Regional ventilation of the lung can be visualized by pulmonary electrical impedance tomography (EIT). The aim of this study was to examine the post‐operative redistribution of regional ventilation after lung surgery dependent on the side of surgery and its association with forced vital capacity. Methods: In this prospective, observational cohort study 13 patients undergoing right and 13 patients undergoing left‐sided open or video‐thoracoscopic procedures have been investigated. Pre‐operative measurements with EIT and spirometry were compared with data obtained 3 days post‐operation. The center of ventilation (COV) within a 32 × 32 pixel matrix was calculated from EIT data. The transverse axis coordinate of COV, COVx (left/right), was modified to COVx′ (ipsilateral/contralateral). Thus, COVx′ shows a negative change if ventilation shifts contralateral independent of the side of surgery. This enabled testing with two‐way ANOVA for repeated measurements (side, time). Results: The perioperative shift of COVx′ was dependent on the side of surgery (P = .007). Ventilation shifted away from the side of surgery after the right‐sided surgery (COVx′‐1.97 pixel matrix points, P < .001), but not after the left‐sided surgery (COVx′‐0.61, P = .425). The forced vital capacity (%predicted) decreased from 94 (83‐109)% (median [quartiles]; [left‐sided]) and 89 (80‐97)% (right‐sided surgery) to 61 (59‐66)% and 62 (40‐72)% (P < .05), respectively. The perioperative changes in forced vital capacity (%predicted) were weakly associated with the shift of COVx′. Conclusion: Only after right‐sided lung surgery, EIT showed reduced ventilation on the side of surgery while vital capacity was markedly reduced in both groups.show moreshow less

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Metadaten
Author: Martin Lehmann, Beatrice Oehler, Jonas Zuber, Uwe Malzahn, Thorsten Walles, Ralf M. Muellenbach, Norbert Roewer, Markus KredelORCiD
URN:urn:nbn:de:bvb:20-opus-213575
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Anästhesiologie (ab 2004)
Language:English
Parent Title (English):Acta Anaesthesiologica Scandinavica
Year of Completion:2020
Volume:64
Issue:4
Pagenumber:517-525
Source:Acta Anaesthesiologica Scandinavica 2020, 64(4):517-525. DOI: 10.1111/aas.13525
DOI:https://doi.org/10.1111/aas.13525
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:electrical impedance tomography; general anaesthesia; one‐lung ventilation; postoperative complications; pulmonary function tests; pulmonary surgical procedures
Release Date:2020/10/20
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International