Clinical benefits of EIT
EIT-based, regional lung function monitoring has the potential to optimize mechanical ventilation, to reduce ventilator-induced lung injuries and to shorten the duration of mechanical ventilation. In general, EIT monitoring can be useful in different situations and environments, e.g. anesthetic procedures or non-invasive ventilation, to have a continuous non-invasive assessment of lung function. Below is a non-exhaustive list with a few examples.
In neonatal patients, EIT is expected to help in the choice between intubation and non-invasive ventilation, in assessing surfactant therapy or to identify potentially harmful conditions such as displacement of the endotracheal tube, pneumothorax, and pleural effusion [1, 2]. In comparison to standard care, use of EIT in preterm neonates is furthermore expected to result in cost-savings, lower mortality and BPD rates . SenTec skin-friendly textile LuMon™ Belts have been found to be suitable for patients whose skin require particular attention as for example preterm newborns .
In adult and pediatric patients, EIT has proven useful in optimizing ventilator settings in critically ill patients suffering from ARDS . It has also shown helpful in assessing lung collapse and lung over-distention [6, 7] and therefore can play an important role in personalizing PEEP settings [8, 9]. Furthermore, EIT can also help to reduce atelectasis, e.g. postoperatively, or to guide protective ventilation strategies .
General benefits of EIT
- Noninvasive & radiation-free
- Less need for complex intra-hospital transfers of intensive care patients which is costly and prone to complications
Particular benefits of SenTec EIT include
- Very compact & lightweight EIT System enabling lung function monitoring at the bedside and, if an internal battery is provided as for the LuMon™ Monitor, during intra-hospital transport
- If used in a standalone configuration, SenTec EIT is mobile, therefore can benefit multiple patients
- Just one connector cable needed to link SenTec’s textile EIT belts to devices implementing SenTec EIT
- Skin friendly, single-patient-use textile EIT belts distinguishing themselves by
- a structured fabric embodying 32 electrodes without a separate reference electrode enabling easy application and removal of the belts to and from the patient, respectively
- an outstanding next-to-skin comfort
- an adhesive-free belt/skin interface being particularly important for patients with sensitive and fragile skin such as preterm neonates.
- a tight fit and good belt-to-skin contact quality without constricting breathing or increasing work of breathing
- minimized risk for skin lesions and cross contamination
Furthermore, inadvertent belt displacement around the patient’s thorax
- is avoided by shoulder straps in case of belts for Adults / Children
- easily can be measured and entered as input via the GUI for compensation by SenTec’s EIT algorithms when using belts for Neonates / Infants.
- Superior data quality due to
- use of unique thorax and lung contours models being derived from computed tomography (CT) and best adapted to each patient
- focus on data and images within the aforementioned lung contours
- Plethysmogram and thereof derived Respiratory Rate (RRi)
- Up to 24-hours trends of parameters reflecting end-expiratory lung volume, end-inspiratory lung volume and mean lung volume along with RRi
- Applicable under virtually all breathing conditions due to the availability of different Analysis Modes supporting analysis of episodes with a) regular breathing patterns, b) breathing patterns that present significant variations in amplitude and/or frequency, and c) with no clear breathing patterns.
- Possibility to assess the influence of the patient’s position and, hence, gravity on lung mechanics and ventilation distribution in the lung, e.g. the effects of therapeutic positioning, can be managed individually as needed instead of flying blind according to standardized protocols
- Silent Spaces Image providing intuitive and continuous visualization of
- the Center of Ventilation (CoV), an abstract measure of ventilation distribution, and the Center of homogeneous Ventilation (CoVhom)
- Silent Spaces, i.e. lung areas receiving no or little ventilation, as well as of their subdivision in Dependent Silent Spaces (DSS) and Non-dependent Silent Spaces (NSS) occurring below or above the Center of Ventilation (CoV), respectively. This subdivision is meaningful insofar as gravity influences the ventilation distribution and may point to a different pathophysiology, e.g. DSS may be due to collapse or fluid accumulation in alveoli while NSS may rather be due to over-distension
- Functional Lung Spaces (FLS), i.e. the lung areas receiving ventilation, reflecting the percentage of the aerated remaining lung  and sometimes referred to as the size of the available lung volume.
- Up to 24-hours trends of DSS, NSS, FLS along with the CoV’s vertical component
- Intuitive and continuous indication of signal quality and of electrodes having bad or no impedance coupling to the skin (so-called failing electrodes)
- Improved performance during challenging situations such a patient movement thanks to advanced signal processing techniques enabling, for example, compensation of up to 6 failing electrodes
 Masner et al.: Electrical impedance tomography for neonatal ventilation assessment: a narrative review. IOP Conf. Series: Journal of Physics: Conf. Series 2019.
 Rahtu et al.: Early Recognition of Pneumothorax in Neonatal Respiratory Distress Syndrome with Electrical Impedance Tomography. Am J Respir Crit Care Med. 2019.
 Voermans A, Mewes J, van Kaam A, Bayford R, Lepage-Nefkens I. Early cost-effectiveness analysis of continuous monitoring of lung-aeration with electrical impedance tomography in preterm neonates with respiratory distress syndrome. Presented at ISPOR Europe 2019, Copenhagen, Denmark.
 Becher et al.: Feasibility and safety of prolonged continuous monitoring with electrical impedance tomography in neonates and infants with respiratory failure. Intensive Care Med. Exp. 2019 7 (Suppl 3):55, 209-210.
 Bachmann et al.: Electrical impedance tomography in acute respiratory distress syndrome. Critical Care 2018: 22-263.
 Gómez-Laberge et al.: A unified approach for EIT imaging of regional overdistension and atelectasis in acute lung injury. IEEE Trans Med Imaging. 2012 Mar; 31(3):834-42.
 Spadaro et al.: Variation of poorly ventilated lung units (silent spaces) measured by electrical impedance tomography to dynamically assess recruitment. Critical Care 2018: 22-26.
 Zhao et al.: Positive end‑expiratory pressure titration with electrical impedance tomography and pressure–volume curve in severe acute respiratory distress syndrome. Ann. Intensive Care 2019: 9-7.
 Ukere et al.: Perioperative assessment of regional ventilation during changing body positions and ventilation conditions by electrical impedance tomography. British Journal of Anaesthesia 2016: 228–35.
 Pereira et al.: Individual positive end-expiratory pressure settings optimize intraoperative mechanical ventilation and reduce postoperative atelectasis. American Society of Anesthesiologists 2018.
 Marcelo B.P. Amato, et al., “Driving Pressure and Survival in the Acute Respiratory Distress Syndrome”, N Engl J Med 2015; 372:747-55. DOI: 10.1056/NEJMsa1410639.