OBJECTIVE: 

To describe, through a narrative review, the physiologic principles underlying electrical impedance tomography, and its potential applications in managing acute respiratory distress syndrome (ARDS). To address the current evidence supporting its use in different clinical scenarios along the ARDS management continuum.

DATA SOURCES: 

We performed an online search in Pubmed to review articles. We searched MEDLINE, Cochrane Central Register, and clinicaltrials.gov for controlled trials databases.

STUDY SELECTION: 

Selected publications included case series, pilot-physiologic studies, observational cohorts, and randomized controlled trials. To describe the rationale underlying physiologic principles, we included experimental studies.

DATA EXTRACTION: 

Data from relevant publications were reviewed, analyzed, and its content summarized.

DATA SYNTHESIS: 

Electrical impedance tomography is an imaging technique that has aided in understanding the mechanisms underlying multiple interventions used in ARDS management. It has the potential to monitor and predict the response to prone positioning, aid in the dosage of flow rate in high-flow nasal cannula, and guide the titration of positive-end expiratory pressure during invasive mechanical ventilation. The latter has been demonstrated to improve physiologic and mechanical parameters correlating with lung recruitment. Similarly, its use in detecting pneumothorax and harmful patient-ventilator interactions such as pendelluft has been proven effective. Nonetheless, its impact on clinically meaningful outcomes remains to be determined.

CONCLUSIONS: 

Electrical impedance tomography is a potential tool for the individualized management of ARDS throughout its different stages. Clinical trials should aim to determine whether a specific approach can improve clinical outcomes in ARDS management.

中文翻译：

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电阻抗断层扫描在急性呼吸窘迫综合征治疗中的应用

客观的： 

通过叙述性回顾来描述电阻抗断层扫描的生理原理及其在治疗急性呼吸窘迫综合征 (ARDS) 方面的潜在应用。解决当前证据支持其在 ARDS 管理连续体的不同临床场景中的使用。

数据源： 

我们在 Pubmed 中进行了在线搜索以评论文章。我们检索了 MEDLINE、Cochrane Central Register 和 ClinicalTrials.gov 的对照试验数据库。

研究选择： 

选定的出版物包括病例系列、试点生理学研究、观察队列和随机对照试验。为了描述生理原理的基本原理，我们进行了实验研究。

数据提取： 

对相关出版物的数据进行了审查、分析，并总结了其内容。

数据综合： 

电阻抗断层扫描是一种成像技术，有助于了解 ARDS 管理中多种干预措施的潜在机制。它具有监测和预测俯卧位反应的潜力，有助于调整高流量鼻插管中的流量剂量，并指导有创机械通气期间呼气末正压的滴定。后者已被证明可以改善与肺复张相关的生理和机械参数。同样，它在检测气胸和有害的患者与呼吸机相互作用（例如 pendelluft）方面的使用已被证明是有效的。尽管如此，其对具有临床意义的结果的影响仍有待确定。

结论： 

电阻抗断层扫描是 ARDS 不同阶段个体化管理的潜在工具。临床试验的目的应是确定特定方法是否可以改善 ARDS 管理的临床结果。