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Electrical impedance tomography detects changes in ventilation after airway clearance in spinal muscular atrophy type I
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2021-08-13 , DOI: 10.1016/j.resp.2021.103773
Andre Viera Pigatto 1 , Tzu-Jen Kao 2 , Jennifer L Mueller 3 , Christopher D Baker 4 , Emily M DeBoer 4 , Oren Kupfer 4
Affiliation  

The effect of mechanical insufflation-exsufflation (MIE) for airway clearance in patients with spinal muscular atrophy type I (SMA‐I) on the distribution of ventilation in the lung is unknown, as is the duration of its beneficial effects. A pilot study to investigate the feasibility of using three dimensional (3-D) electrical impedance tomography (EIT) images to estimate lung volumes pre- and post-MIE for assessing the effectiveness of mechanical insufflation-exsufflation (MIE) was conducted in 6 pediatric patients with SMA‐I in the neuromuscular clinic at Children's Hospital Colorado. EIT data were collected before, during, and after the MIE procedure on two rows of 16 electrodes placed around the chest. Lung volumes were computed from the images and compared before, during, and after the MIE procedure to assess the ability of EIT to estimate changes in lung volume during insufflation and exsufflation. Images of pulsatile pulmonary perfusion were computed in subjects able to perform breath-holding. In four of the six subjects, lung volumes during tidal breathing increased after MIE (average change from pre to post MIE was 58.8±55.1 mL). The time-dependent plots of lung volume computed from the EIT data clearly show when the MIE device insufflates and exsufflates air and the rest periods between mechanical coughs. Images of pulmonary pulsatile perfusion were computed from data collected during breathing pauses. The results suggest that EIT holds promise for estimating lung volumes and ventilation/perfusion mismatch, both of which are useful for assessing the effectiveness of MIE in clearing mucus plugs.



中文翻译:

电阻抗断层扫描检测 I 型脊髓性肌萎缩症患者气道清除后通气的变化

机械注气-排气 (MIE) 对 I 型脊髓性肌萎缩症 (SMA-I) 患者气道清除的影响对肺部通气分布的影响及其有益效果的持续时间尚不清楚。在 6 名儿科中进行了一项初步研究,以调查使用三维 (3-D) 电阻抗断层扫描 (EIT) 图像来估计 MIE 前后肺体积以评估机械注气-排气 (MIE) 的有效性的可行性。科罗拉多州儿童医院神经肌肉诊所的 SMA-I 患者。EIT 数据是在 MIE 手术之前、期间和之后在胸部周围放置的两排 16 个电极上收集的。从图像计算肺体积,并在之前、期间、并在 MIE 程序之后评估 EIT 在吹入和吹出期间估计肺容量变化的能力。在能够进行屏气的受试者中计算脉动肺灌注图像。在六名受试者中的四名中,潮式呼吸期间的肺容量在 MIE 后增加(从 MIE 前后的平均变化为 58.8±55.1 mL)。从 EIT 数据计算的肺容积的时间相关图清楚地显示了 MIE 设备何时注入和排出空气以及机械咳嗽之间的休息时间。根据呼吸暂停期间收集的数据计算肺搏动灌注图像。结果表明,EIT 有望用于估计肺容量和通气/灌注不匹配,这两者都有助于评估 MIE 在清除粘液栓方面的有效性。

更新日期:2021-08-26
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