The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


John S. Emberger1, Joel Brown1, Vinay Maheshwari1, Gerard Fulda2, John Getchell2; 1Respiratory Care, Christiana Care Health System, Newark, DE; 2Surgery, Christiana Care Health System, Newark, DE

BACKGROUND: EIT is a lung function monitoring technique using electrodes conducting impedance measurements. Changes in ventilation cause changes of impedance which can be displayed as cross-sectional images representing regional distribution of ventilation. EIT had not been feasible due to the process of securing many electrodes to the chest. A device (EIT Evaluation Kit 2, Draeger Medical, Luebeck Germany) using an elastic electrode belt may make bedside EIT feasible. We conducted an IRB approved feasibility study of EIT. METHOD: EIT was conducted on consented patients up to 6 hours/day over three days. Researchers observed and stored EIT data on the device. Caregivers were blinded to EIT data and EIT was not used to guide patient care. A properly sized electrode belt was placed on each patient during routine re-positioning. There are 5 different sized belts. Feasibility was observed including ease of placing the belt and initiating EIT monitoring. Issues affecting the ability to maintain EIT monitoring were observed. RESULTS: 13 patients were monitored with EIT (8 females). 27 days total of EIT monitoring were performed. Consent was not sought on 2 potential patients due to chest tube dressings covering EIT belt location. Consent was not sought on 1 potential patient due to pacemaker. 2 patients were monitored despite chest tube dressings. 2 patients were monitored with body weight > 300 pounds. Electrode belt placement was completed in less than 10 minutes. The belt was functional without electrode gel, however gel was used on 3 patients who had subjectively dry skin. EIT monitoring was always initiated in less than 20 minutes from entering the room. EIT required restart/re-zeroing on 5 patients periodically during the monitoring period. This was required due to vibration of the electrodes; vibrating (percussion) bed and patient agitation. Awake and alert patients were successfully monitored if not agitated. No skin breakdown/irritation occurred. Chest hair and breast tissue was not noted as affecting the EIT monitoring. CONCLUSION: EIT monitoring is feasible and can be quickly initiated at bedside with the use of a new elastic electrode belt depending on the following factors: 1)skin is intact and not covered with a dressing 2) patient is not agitated or being percussed 3) patient fits the electrode belt - EIT was successful in patients greater than 300 pounds. EIT is feasible and may be a valuable tool for monitoring regional lung ventilation.
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Manikin with EIT Chest Belt