Use of Electric Impedance Tomography as a Screening Tool to Determine Effectiveness of Bronchosopy in a VV-ECMO Patient.

Introduction: Electrical impedance tomography (EIT) is a real-time, noninvasive, bedside evaluation method of regional lung ventilation. EIT screening experience is presented in a patient with VV-ECMO and used bronchoscopy due to atelectasis. Case: A 46-year-old female patient diagnosed with microscopic polyangitis with diffuse bilateral lung infitrations.While being followed with pulse steroid therapy and high flow oxygen, she was intubated after rapid progression and then taken to VV-ECMO. The cause of progression was found to be diffuse pneumonia in the left hemithorax, and meropenem was started rapidly. Steroid therapy of the patient was gradually reduced. Bronchoscopy was performed. EIT monitorization was applied to the patient to evaluate the lung vantilation before and after bronchoscopy. Consistent with the chest radiograph before bronchoscopy, severe vantilation impairment was observed in the left lung, especially in the lower zones. It was observed that left lung ventilation and tidal volumes increased within hours after bronchoscopy. The patient was successfully extubated 3 days after weaning from VV-ECMO and transferred to the service. Discussion: EIT is as a new functional imaging modality that provides instant visualization of the dynamic state of the lung during ventilation. It’s use without using ionizing radiation and in-hospital transport is an important advantage in ECMO as in our patient or in ventilator-dependent patients. In our patient, secretion clearance and removal of atelectasis with bronchoscopy were visualized instantly at the bedside with EIT. Increase in ventilation at the left lung was observed after bronchoscopy. As a result; Bedside EIT monitoring is a method that allows rapid evaluation of ventilation in critically ill patients during bronchoscopy, and it can provide significant benefits in the clinical decisions of patients with VVECMO. [ABSTRACT FROM AUTHOR]