The assessment of regional lung mechanics with electrical impedance tomography: a pilot study during recruitment manoeuvres

Objective The purpose of lung recruitment manoeuvres is to open collapsed lung regions, improve gas exchange and optimise regional lung mechanics. This study investigates the efficacy of recruitment manoeuvres for improving regional ventilation distribution as characterised using electrical impedance tomography (EIT). Design, subjects, interventions A ventilated ovine smoke inhalation lung injury model was used. Respiratory mechanics and regional filling capacity of the lung were measured using EIT pre- and post- recruitment and compared to a control group. Measurements EIT, expressed as the time course relation of the regional versus the global impedance change, measured the regional filling capacities of the lung. Main results After smoke inhalation injury, the dependent lung showed a significantly larger area of collapse and a reduced filling capacity compared to the non-dependent lung. After recruitment the ventilated volume increased and the dependent lung showed improved respiratory mechanics, whereas the non-dependent lung was more likely to be hyper-inflated during tidal breathing. Conclusions Lung recruitment manoeuvres have a significant impact on regional lung mechanics and individual measurement of ventilation distribution using EIT may assist to improve ventilatory management. Electronic supplementary material The online version of this article (doi:10.1007/s00134-008-1324-0) contains supplementary material, which is available to authorized users.