Regional ventilation by electrical impedance tomography - A comparison with ventilation scintigraphy in pigs

Study objective: The validation of electrical impedance tomography (EIT) for measuring regional ventilation distribution by comparing it with single photon emission CT (SPECT) scanning. Design: Randomized, prospective animal study. Settings: Animal laboratories and nuclear medicine laboratories at a university hospital. Participants: Twelve anesthetized and mechanically ventilated pigs. Interventions: Lung injury was induced by central venous injection of oleic acid. Then pigs were randomized to pressure-controlled mechanical ventilation, airway pressure-release ventilation, or spontaneous breathing. Measurements and results: Ventilation distribution was assessed by EIT using cross-sectional electrotomographic measurements of the thorax, and simultaneously by single SPECT scanning with the inhalation of Tc-99m-labeled carbon particles. For both methods, the evaluation of ventilation distribution was performed in the same transverse slice that was approximately 4 cm in thickness. The transverse slice then was divided into 20 coronal segments (going from the sternum to the spine). We compared the percentage of ventilation in each segment, normalized to the entire ventilation in the observed slice. Our data showed an excellent linear correlation between the ventilation distribution measured by SPECT scanning and EIT according to the following equation: y = 0.82x + 0.7,(R-2 = 0.92; range, 0.86 to 0.97). Conclusion: Based on these data, EIT seems to allow, at least in comparable states of lung injury, real-time monitoring of regional ventilation distribution at the bedside.