Electrical Impedance Tomography Can Be Used to Quantify Lung Hyperinflation during HFOV: The Pilot Study in Pigs

Abstract

Dynamic hyperinflation is reported as a potential risk during high-frequency oscillatory ventilation (HFOV), and its existence has been documented both by physical models and by CT. The aim of this study is to determine the suitability of electrical impendence tomography (EIT) for the measurement of dynamic lung hyperinflation and hypoinflation during HFOV. Eleven healthy pigs were anaesthetized and ventilated using HFOV. The difference between the airway pressure at the airway opening and alveolar space was measured by EIT and esophageal balloons at three mean airway pressures (12, 18 and 24 cm H2O) and two inspiratory to expiratory time ratios (1:1, 1:2). The I:E ratio was the primary parameter associated with differences between airway and alveolar pressures. All animals showed hyperinflation at a 1:1 ratio (median 1.9 cm H2O) and hypoinflation at a 1:2 (median –4.0 cm H2O) as measured by EIT. EIT measurements had a linear correlation to esophageal balloon measurements (r2 = –0.915, p = 0.0085). EIT measurements were slightly higher than that of the esophageal balloon transducer with the mean difference of 0.57 cm H2O. Presence of a hyperinflation or hypoinflation was also confirmed independently by chest X-ray. We found that dynamic hyperinflation developed during HFOV may be detected and characterized noninvasively by EIT.