Chest electrical impedance tomography measures in neonatology and paediatrics-a survey on clinical usefulness

Objective: Chest electrical impedance tomography (EIT) is currently applied in neonatal and paediatric patients, mainly within clinical studies. The findings of these studies imply that lung monitoring using EIT provides valuable information on regional lung ventilation and aeration at the bedside that might improve the therapy and care of this fragile patient population. In view of this postulated future use of EIT in neonatology and paediatrics we have conducted an international survey to assess the perceived usefulness of several measures derived from EIT examinations. Approach: A questionnaire validating the clinical usefulness of 14 previously described EIT measures was designed and sent to 36 clinicians with previous experience with EIT in neonatal and paediatric patients. A numerical rating scale was used to assess the usefulness of each measure. Main results: Thirty-four clinicians from 12 countries responded to the invitation and 32 filled in the questionnaire. The mean clinical and EIT experience (+/- SD) of the respondents was 19.4 +/- 9.1 years and 7.7 +/- 5.8 years, respectively. The top-rated measures were the global inhomogeneity index, silent spaces, change in end-expiratory lung impedance and ventrodorsal centre of ventilation. The bottom-rated were the regional respiratory time constant, tidal volume normalised to ml, respiratory rate and heart rate on the last rank. Significance: The survey revealed that EIT measures characterising the ventilation and aeration distribution and the degree of their heterogeneity were deemed particularly useful. Respiratory rate, heart rate and overall tidal volume were considered less useful probably because these parameters are already routinely assessed by other conventional methods.