Monitoring of regional ventilation distribution using electrical
impedance tomography in pediatric patients with chest physiotherapy -- a
feasibility study.
Abstract
Background It remains unclear if pediatric patients with acute or
chronic lung diseases benefit from chest physiotherapy (CPT) during
spontaneous breathing. The electrical impedance tomography (EIT) offers
the opportunity to assess treatment effects of CPT on regional
ventilation distributions. Methods We conducted a prospective
feasibility study between 10/2023 to 05/2024. Pediatric patients with
need for active or passive CPT were screened. EIT measurements were
performed at (T1) immediately prior to CPT intervention, and (T2) within
30 minutes after CPT intervention. Results Overall, 25 patients were
enrolled, with two patients enrolled twice at different admissions,
resulting in 54 EIT-measurements. The mean horizontal center of
ventilation (CoVx) and the mean vertical CoVy were equally distributed
at T1 and T2, without any difference seen when subdividing for mode of
CPT. The mean global inhomogeneity index (GI) decreased from 0.38 to
0.36 (∆GI: -6%, p=0.939) in the overall cohort, with a significant
decrease between T1 and T2 in patients with active (∆GI: -10%,
p=0.015), but not in patients with passive CPT (∆GI: +6%, p=0.199). In
patients with a localized pulmonary finding in the radiologic assessment
(n=10) we observed a markedly increase of the proportional ventilation
distribution of the affected lung side after CPT (T1:44% vs. T2: 48%,
p=0.057). Conclusion EIT seems feasible to monitor changes in regional
ventilation distribution after CPT in pediatric patients. Patients with
localized pulmonary radiological findings and patients after active CPT
seems to benefit most from CPT, whereas there is a subset of individuals
with no response to CPT.