Regional lung response to bronchodilator reversibility testing determined by electrical impedance tomography in chronic obstructive pulmonary disease

被引：50

作者：

Vogt, Barbara ^{[1
]}

Zhao, Zhanqi ^{[2
]}

Zabel, Peter ^{[3
]}

Weiler, Norbert ^{[1
]}

Frerichs, Inez ^{[1
]}

机构：

[1] Univ Med Ctr Schleswig Holstein, Dept Anesthesiol & Intens Care Med, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany

[2] Furtwangen Univ, Dept Biomed Engn, Villingen Schwenningen, Germany

[3] Res Ctr Borstel, Med Clin, Dept Pneumol, Borstel, Germany

来源：

AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY | 2016年 / 311卷 / 01期

关键词：

EIT; pulmonary function testing; COPD; spirometry; ventilation distribution; VENTILATION DISTRIBUTION; REFERENCE VALUES; INFANTS; RESPONSIVENESS; INJURY; VOLUME; EIT; REPRODUCIBILITY; HETEROGENEITY; SPIROMETRY;

D O I：

10.1152/ajplung.00463.2015

中图分类号：

Q4 [生理学];

学科分类号：

071003 ;

摘要：

Regional lung response to bronchodilator reversibility testing determined by electrical impedance tomography in chronic obstructive pulmonary disease. Am J Physiol Lung Cell Mol Physiol 311:L8-L19,2016. First published May 17, 2016; doi: 10.1152/ajplung.00463.2015.-Patients with obstructive lung diseases commonly undergo bronchodilator reversibility testing during examination of their pulmonary function by spirometry. A positive response is defined by an increase in forced expiratory volume in 1 s (FEV1). FEV1 is a rather nonspecific criterion not allowing the regional effects of bronchodilator to be assessed. We employed the imaging technique of electrical impedance tomography (EIT) to visualize the spatial and temporal ventilation distribution in 35 patients with chronic obstructive pulmonary disease at baseline and 5, 10, and 20 min after bronchodilator inhalation. EIT scanning was performed during tidal breathing and forced full expiration maneuver in parallel with spirometry. Ventilation distribution was determined by EIT by calculating the image pixel values of FEV1, forced vital capacity (FVC), tidal volume, peak flow, and mean forced expiratory flow between 25 and 75% of FVC. The global inhomogeneity indexes of each measure and histograms of pixel FEV1/FVC values were then determined to assess the bronchodilator effect on spatial ventilation distribution. Temporal ventilation distribution was analyzed from pixel values of times needed to exhale 75 and 90% of pixel FVC. Based on spirometric FEV1, significant bronchodilator response was found in 17 patients. These patients exhibited higher postbronchodilator values of all regional EIT-derived lung function measures in contrast to nonresponders. Ventilation distribution was inhomogeneous in both groups. Significant improvements were noted for spatial distribution of pixel FEV1 and tidal volume and temporal distribution in responders. By providing regional data, EIT might increase the diagnostic and prognostic information derived from reversibility testing.

引用

页码：L8 / L19

页数：12

共 54 条

[1] Bronchodilator responsiveness as a phenotypic characteristic of established chronic obstructive pulmonary disease [J].

Albert, Paul ;

Agusti, Alvar ;

Edwards, Lisa ;

Tal-Singer, Ruth ;

Yates, Julie ;

Bakke, Per ;

Celli, Bartolome R. ;

Coxson, Harvey O. ;

Crim, Courtney ;

Lomas, David A. ;

MacNee, William ;

Miller, Bruce ;

Rennard, Stephen ;

Silverman, Edwin K. ;

Vestbo, Jorgen ;

Wouters, Emiel ;

Calverley, Peter .

THORAX, 2012, 67 (08) :701-708

[2] Electrical impedance tomography can rapidly detect small pneumothoraces in surfactant-depleted piglets [J].

Bhatia, Risha ;

Schmoelzer, Georg M. ;

Davis, Peter G. ;

Tingay, David G. .

INTENSIVE CARE MEDICINE, 2012, 38 (02) :308-315

[3] Unilateral empyema impacts the assessment of regional lung ventilation by electrical impedance tomography [J].

Blaeser, D. ;

Pulletz, S. ;

Becher, T. ;

Schaedler, D. ;

Elke, G. ;

Weiler, N. ;

Frerichs, I. .

PHYSIOLOGICAL MEASUREMENT, 2014, 35 (06) :975-983

[4] Principles of electrical impedance tomography and its clinical application [J].

Bodenstein, Marc ;

David, Matthias ;

Markstaller, Klaus .

CRITICAL CARE MEDICINE, 2009, 37 (02) :713-724

[5]

Brown B. H., 2003, Journal of Medical Engineering & Technology, V27, P97, DOI 10.1080/0309190021000059687

[6] Bronchodilator reversibility testing in chronic obstructive pulmonary disease [J].

Calverley, PMA ;

Burge, PS ;

Spencer, S ;

Anderson, JA ;

Jones, PW .

THORAX, 2003, 58 (08) :659-664

[7] Outcomes for COPD pharmacological trials:: from lung function to biomarkers [J].

Cazzola, M. ;

MacNee, W. ;

Martinez, F. J. ;

Rabe, K. F. ;

Franciosi, L. G. ;

Barnes, P. J. ;

Brusasco, V. ;

Burge, P. S. ;

Calverley, P. M. A. ;

Celli, B. R. ;

Jones, P. W. ;

Mahler, D. A. ;

Make, B. ;

Miravitlles, M. ;

Page, C. P. ;

Palange, P. ;

Parr, D. ;

Pistolesi, M. ;

Rennard, S. I. ;

Moelken, M. P. Rutten-Van ;

Stockley, R. ;

Sullivan, S. D. ;

Wedzicha, J. A. ;

Wouters, E. F. .

EUROPEAN RESPIRATORY JOURNAL, 2008, 31 (02) :416-468

[8] A parametric model of the relationship between EIT and total lung volume [J].

Coulombe, N ;

Gagnon, H ;

Marquis, F ;

Skrobik, Y ;

Guardo, R .

PHYSIOLOGICAL MEASUREMENT, 2005, 26 (04) :401-411

[9] Quantification of ventilation distribution in regional lung injury by electrical impedance tomography and xenon computed tomography [J].

Elke, Gunnar ;

Fuld, Matthew K. ;

Halaweish, Ahmed F. ;

Grychtol, Bartlomiej ;

Weiler, Norbert ;

Hoffman, Eric A. ;

Frerichs, Inez .

PHYSIOLOGICAL MEASUREMENT, 2013, 34 (10) :1303-1318

[10] Reproducibility of regional lung ventilation distribution determined by electrical impedance tomography during mechanical ventilation [J].

Frerichs, I. ;

Schmitz, G. ;

Pulletz, S. ;

Schaedler, D. ;

Zick, G. ;

Scholz, J. ;

Weiler, N. .

PHYSIOLOGICAL MEASUREMENT, 2007, 28 (07) :S261-S267

← 1 2 3 4 5 6 →