Application of electrical impedance tomography in diagnosis and monitoring of pulmonary diseases_Journal of Biomedical Engineering

Authors：

HU Xiaomin ¹ , ZHANG Shuaifu ¹ , CHEN Panfeng ² , DONG Feng ¹ , FAN Haojun ³ , LYU Qi ³ ,  XU Yanbin ¹

1. School of Electrical and Information Engineering, Tianjin University, Tianjin 300072, P. R. China;
2. Department of Respiratory and Critical Care Medicine, Tianjin First Central Hospital, Tianjin 300192, P. R. China;
3. Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, P. R. China;

Corresponding author：

Keywords：

Electrical impedance tomography; Pulmonary disease; Auxiliary diagnosis; Ventilation distribution

DOI：

10.7507/1001-5515.202407072

Video：

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Electrical impedance tomography (EIT) is a new non-invasive functional imaging technology, which has the advantages of non-invasion, non-radiation, low cost, fast response, portability and visualization. In recent years, more and more studies have shown that EIT has great potential in the detection of lung diseases and has been applied to early diagnosis and treatment of some diseases. This paper introduced the basic principle of EIT, discussed the research and clinical application of EIT in the detection of acute respiratory distress syndrome, chronic obstructive pulmonary disease, pneumothorax and pulmonary embolism, and focused on the summary and introduction of indicators and functional images of EIT related to the detection of lung diseases. This review will help medical workers understand and use EIT, and promote the further development of EIT in lung diseases as well as other fields.

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2.	Xu Yuqing, Yang Lin, Lu Shiyue, et al. Emerging trends and hot spots on electrical impedance tomography extrapulmonary applications. Heliyon, 2022, 8(12): e12458.
3.	Levin A I, Pecherskaya E A, Shepeleva J V, et al. Problems in the implementation of electrical impedance tomography// 2023 IEEE 24th International Conference of Young Professionals in Electron Devices and Materials (EDM). Novosibirsk: IEEE, 2023: 1360-1363.
4.	Frerichs I, Amato M B P, Van Kaam A H, et al. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group. Thorax, 2017, 72(1): 83-93.
5.	Heines S J H, Becher T H, van der Horst I C C, et al. Clinical applicability of electrical impedance tomography in patient-tailored ventilation: A narrative review. Tomography, 2023, 9(5): 1903-1932.
6.	Adler A, Holder D. Electrical impedance tomography: methods, history and applications. 2nd ed. Boca Raton: CRC Press, 2021: 1-518.
7.	Jimenez J V, Weirauch A J, Culter C A, et al. Electrical impedance tomography in acute respiratory distress syndrome management. Crit Care Med, 2022, 50(8): 1210-1223.
8.	Matthay M A, Arabi Y, Arroliga A C, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med, 2024, 209(1): 37-47.
9.	Mi L, Chi Y, Yuan S, et al. Effect of prone positioning with individualized positive end-expiratory pressure in acute respiratory distress syndrome using electrical impedance tomography. Front Physiol, 2022, 13: 906302.
10.	孙同文, 张西京, 黎毅敏, 等. 中国成人急性呼吸窘迫综合征(ARDS)诊断与非机械通气治疗指南(2023). 中国研究型医院, 2023, 10(5): 9-24.
11.	Shono A, Kotani T. Clinical implication of monitoring regional ventilation using electrical impedance tomography. J Intensive Care, 2019, 7(1): 4.
12.	周润奭, 隆云, 李尊柱, 等. EIT监测ARDS脱机困难患者早期活动过程中肺部通气变化. 中华重症医学电子杂志, 2021, 7(4): 319-325.
13.	Brabant O, Crivellari B, Hosgood G, et al. Effects of PEEP on the relationship between tidal volume and total impedance change measured via electrical impedance tomography (EIT). J Clin Monit Comput, 2022, 36: 325-334.
14.	Girrbach F, Zeutzschel F, Schulz S, et al. Methods for determination of individual PEEP for intraoperative mechanical ventilation using a decremental PEEP trial. J Clin Med, 2022, 11(13): 3707.
15.	Ren H, Xie L, Wang Z, et al. Comparison of global and regional compliance-guided positive end-expiratory pressure titration on regional lung ventilation in moderate-to-severe pediatric acute respiratory distress syndrome. Front Med, 2022, 9: 805680.
16.	Putensen C, Hentze B, Muenster S, et al. Electrical impedance tomography for cardio-pulmonary monitoring. J Clin Med, 2019, 8(8): 1176.
17.	Cammarota G, Simonte R, Longhini F, et al. Advanced point-of-care bedside monitoring for acute respiratory failure. Anesthesiology, 2023, 138(3): 317-334.
18.	Heines S J H, de Jongh S A M, Strauch U, et al. The global inhomogeneity index assessed by electrical impedance tomography overestimates PEEP requirement in patients with ARDS: an observational study. BMC Anesthesiol, 2022, 22(1): 258.
19.	Bleul U, Wey C, Meira C, et al. Assessment of postnatal pulmonary adaption in bovine neonates using electric impedance tomography (EIT). Animals, 2021, 11(11): 3216.
20.	Maciejewski D, Putowski Z, Czok M, et al. Electrical impedance tomography as a tool for monitoring mechanical ventilation. An introduction to the technique. Adv Med Sci, 2021, 66(2): 388-395.
21.	Hsu H J, Chang H T, Zhao Z, et al. Positive end-expiratory pressure titration with electrical impedance tomography and pressure–volume curve: A randomized trial in moderate to severe ARDS. Physiol Meas, 2021, 42(1): 014002.
22.	Grotberg J C, Reynolds D, Kraft B D. Management of severe acute respiratory distress syndrome: a primer. Crit Care, 2023, 27(1): 289.
23.	梁振宇, 陈荣昌. 慢性阻塞性肺疾病诊疗指南(2021年修订版)修订历程及思考. 中华结核和呼吸杂志, 2021, 44(3): 165-166.
24.	Venkatesan P. GOLD COPD report: 2024 update. Lancet Respir Med, 2024, 12(1): 15-16.
25.	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 中国慢性阻塞性肺疾病基层诊疗与管理指南(2024年). 中华全科医师杂志, 2024, 23(6): 578-602.
26.	Zhang C, Dai M, Liu W, et al. Global and regional degree of obstruction determined by electrical impedance tomography in patients with obstructive ventilatory defect. PLoS ONE, 2018, 13(12): e0209473.
27.	Frerichs I, Lasarow L, Strodthoff C, et al. Spatial ventilation inhomogeneity determined by electrical impedance tomography in patients with chronic obstructive lung disease. Front Physiol, 2021, 12: 762791.
28.	Zouari F, Cheung P T, Touboul A, et al. Global and regional lung function assessment using portable electrical impedance tomography (EIT) system: clinical study// 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC). Sydney: IEEE, 2023: 1-4.
29.	Yang Y, He H, Long Y, et al. Bedside electrical impedance tomography in early diagnosis of pneumothorax in mechanically ventilated ICU patients—A single-center retrospective cohort study. J Clin Monit Comput, 2023, 37(2): 629-637.
30.	Gao Z, Yang L, Zhao Z, et al. Monitoring of spontaneous pneumothorax using electrical impedance tomography: A case report. Heliyon, 2024, 10(3): e25405.
31.	Miedema M, Adler A, McCall K E, et al. Electrical impedance tomography identifies a distinct change in regional phase angle delay pattern in ventilation filling immediately prior to a spontaneous pneumothorax. J Appl Physiol, 2019, 127(3): 707-712.
32.	Preis C, Luepschen H, Leonhardt S, et al. Experimental case report: development of a pneumothorax monitored by electrical impedance tomography. Clin Physiol Funct Imaging, 2009, 29(3): 159-162.
33.	侯顺欣, 姜海明. 肺栓塞的诊断与治疗研究进展. 中国医药指南, 2023, 21(1): 62-65.
34.	Xu M, He H, Long Y. Lung perfusion assessment by bedside electrical impedance tomography in critically ill patients. Front Physiol, 2021, 12: 748724.
35.	王禹娴, 钟鸣. 电阻抗断层成像技术监测肺血流的临床应用. 中华医学杂志, 2022, 102(36): 6.
36.	Prins S A, Weller D, Labout J A M, et al. Electrical impedance tomography as a bedside diagnostic tool for pulmonary embolism. Crit care explor, 2023, 5(1): e0843.
37.	Yuan S, He H, Long Y, et al. Rapid dynamic bedside assessment of pulmonary perfusion defect by electrical impedance tomography in a patient with acute massive pulmonary embolism. Pulm Circ, 2021, 11(1): 1-3.
38.	Nguyen D T, Bhaskaran A, Chik W, et al. Perfusion redistribution after a pulmonary-embolism-like event with contrast enhanced EIT. Physiol Meas, 2015, 36(6): 1297.
39.	熊俞朗, 刘成伟. 肺栓塞的再灌注治疗进展. 临床肺科杂志, 2023, 28(5): 741-744.
40.	Wang X, Zhao H, Cui N. The role of electrical impedance tomography for management of high-risk pulmonary embolism in a postoperative patient. Front Med, 2021, 8: 773471.
41.	何怀武, 隆云, 池熠, 等. 床旁高渗盐水造影肺灌注电阻抗断层成像的技术规范与临床应用. 中华医学杂志, 2021, 101(15): 1097-1101.
42.	Hentze B, Muders T, Luepschen H, et al. Regional lung ventilation and perfusion by electrical impedance tomography compared to single-photon emission computed tomography. Physiol Meas, 2018, 39(6): 065004.

1. Levine S M, Marciniuk D D. Global impact of respiratory disease: What can we do, together, to make a difference?. Chest, 2022, 161(5): 1153-1154.
2. Xu Yuqing, Yang Lin, Lu Shiyue, et al. Emerging trends and hot spots on electrical impedance tomography extrapulmonary applications. Heliyon, 2022, 8(12): e12458.
3. Levin A I, Pecherskaya E A, Shepeleva J V, et al. Problems in the implementation of electrical impedance tomography// 2023 IEEE 24th International Conference of Young Professionals in Electron Devices and Materials (EDM). Novosibirsk: IEEE, 2023: 1360-1363.
4. Frerichs I, Amato M B P, Van Kaam A H, et al. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group. Thorax, 2017, 72(1): 83-93.
5. Heines S J H, Becher T H, van der Horst I C C, et al. Clinical applicability of electrical impedance tomography in patient-tailored ventilation: A narrative review. Tomography, 2023, 9(5): 1903-1932.
6. Adler A, Holder D. Electrical impedance tomography: methods, history and applications. 2nd ed. Boca Raton: CRC Press, 2021: 1-518.
7. Jimenez J V, Weirauch A J, Culter C A, et al. Electrical impedance tomography in acute respiratory distress syndrome management. Crit Care Med, 2022, 50(8): 1210-1223.
8. Matthay M A, Arabi Y, Arroliga A C, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med, 2024, 209(1): 37-47.
9. Mi L, Chi Y, Yuan S, et al. Effect of prone positioning with individualized positive end-expiratory pressure in acute respiratory distress syndrome using electrical impedance tomography. Front Physiol, 2022, 13: 906302.
10. 孙同文, 张西京, 黎毅敏, 等. 中国成人急性呼吸窘迫综合征(ARDS)诊断与非机械通气治疗指南(2023). 中国研究型医院, 2023, 10(5): 9-24.
11. Shono A, Kotani T. Clinical implication of monitoring regional ventilation using electrical impedance tomography. J Intensive Care, 2019, 7(1): 4.
12. 周润奭, 隆云, 李尊柱, 等. EIT监测ARDS脱机困难患者早期活动过程中肺部通气变化. 中华重症医学电子杂志, 2021, 7(4): 319-325.
13. Brabant O, Crivellari B, Hosgood G, et al. Effects of PEEP on the relationship between tidal volume and total impedance change measured via electrical impedance tomography (EIT). J Clin Monit Comput, 2022, 36: 325-334.
14. Girrbach F, Zeutzschel F, Schulz S, et al. Methods for determination of individual PEEP for intraoperative mechanical ventilation using a decremental PEEP trial. J Clin Med, 2022, 11(13): 3707.
15. Ren H, Xie L, Wang Z, et al. Comparison of global and regional compliance-guided positive end-expiratory pressure titration on regional lung ventilation in moderate-to-severe pediatric acute respiratory distress syndrome. Front Med, 2022, 9: 805680.
16. Putensen C, Hentze B, Muenster S, et al. Electrical impedance tomography for cardio-pulmonary monitoring. J Clin Med, 2019, 8(8): 1176.
17. Cammarota G, Simonte R, Longhini F, et al. Advanced point-of-care bedside monitoring for acute respiratory failure. Anesthesiology, 2023, 138(3): 317-334.
18. Heines S J H, de Jongh S A M, Strauch U, et al. The global inhomogeneity index assessed by electrical impedance tomography overestimates PEEP requirement in patients with ARDS: an observational study. BMC Anesthesiol, 2022, 22(1): 258.
19. Bleul U, Wey C, Meira C, et al. Assessment of postnatal pulmonary adaption in bovine neonates using electric impedance tomography (EIT). Animals, 2021, 11(11): 3216.
20. Maciejewski D, Putowski Z, Czok M, et al. Electrical impedance tomography as a tool for monitoring mechanical ventilation. An introduction to the technique. Adv Med Sci, 2021, 66(2): 388-395.
21. Hsu H J, Chang H T, Zhao Z, et al. Positive end-expiratory pressure titration with electrical impedance tomography and pressure–volume curve: A randomized trial in moderate to severe ARDS. Physiol Meas, 2021, 42(1): 014002.
22. Grotberg J C, Reynolds D, Kraft B D. Management of severe acute respiratory distress syndrome: a primer. Crit Care, 2023, 27(1): 289.
23. 梁振宇, 陈荣昌. 慢性阻塞性肺疾病诊疗指南(2021年修订版)修订历程及思考. 中华结核和呼吸杂志, 2021, 44(3): 165-166.
24. Venkatesan P. GOLD COPD report: 2024 update. Lancet Respir Med, 2024, 12(1): 15-16.
25. 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 中国慢性阻塞性肺疾病基层诊疗与管理指南(2024年). 中华全科医师杂志, 2024, 23(6): 578-602.
26. Zhang C, Dai M, Liu W, et al. Global and regional degree of obstruction determined by electrical impedance tomography in patients with obstructive ventilatory defect. PLoS ONE, 2018, 13(12): e0209473.
27. Frerichs I, Lasarow L, Strodthoff C, et al. Spatial ventilation inhomogeneity determined by electrical impedance tomography in patients with chronic obstructive lung disease. Front Physiol, 2021, 12: 762791.
28. Zouari F, Cheung P T, Touboul A, et al. Global and regional lung function assessment using portable electrical impedance tomography (EIT) system: clinical study// 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC). Sydney: IEEE, 2023: 1-4.
29. Yang Y, He H, Long Y, et al. Bedside electrical impedance tomography in early diagnosis of pneumothorax in mechanically ventilated ICU patients—A single-center retrospective cohort study. J Clin Monit Comput, 2023, 37(2): 629-637.
30. Gao Z, Yang L, Zhao Z, et al. Monitoring of spontaneous pneumothorax using electrical impedance tomography: A case report. Heliyon, 2024, 10(3): e25405.
31. Miedema M, Adler A, McCall K E, et al. Electrical impedance tomography identifies a distinct change in regional phase angle delay pattern in ventilation filling immediately prior to a spontaneous pneumothorax. J Appl Physiol, 2019, 127(3): 707-712.
32. Preis C, Luepschen H, Leonhardt S, et al. Experimental case report: development of a pneumothorax monitored by electrical impedance tomography. Clin Physiol Funct Imaging, 2009, 29(3): 159-162.
33. 侯顺欣, 姜海明. 肺栓塞的诊断与治疗研究进展. 中国医药指南, 2023, 21(1): 62-65.
34. Xu M, He H, Long Y. Lung perfusion assessment by bedside electrical impedance tomography in critically ill patients. Front Physiol, 2021, 12: 748724.
35. 王禹娴, 钟鸣. 电阻抗断层成像技术监测肺血流的临床应用. 中华医学杂志, 2022, 102(36): 6.
36. Prins S A, Weller D, Labout J A M, et al. Electrical impedance tomography as a bedside diagnostic tool for pulmonary embolism. Crit care explor, 2023, 5(1): e0843.
37. Yuan S, He H, Long Y, et al. Rapid dynamic bedside assessment of pulmonary perfusion defect by electrical impedance tomography in a patient with acute massive pulmonary embolism. Pulm Circ, 2021, 11(1): 1-3.
38. Nguyen D T, Bhaskaran A, Chik W, et al. Perfusion redistribution after a pulmonary-embolism-like event with contrast enhanced EIT. Physiol Meas, 2015, 36(6): 1297.
39. 熊俞朗, 刘成伟. 肺栓塞的再灌注治疗进展. 临床肺科杂志, 2023, 28(5): 741-744.
40. Wang X, Zhao H, Cui N. The role of electrical impedance tomography for management of high-risk pulmonary embolism in a postoperative patient. Front Med, 2021, 8: 773471.
41. 何怀武, 隆云, 池熠, 等. 床旁高渗盐水造影肺灌注电阻抗断层成像的技术规范与临床应用. 中华医学杂志, 2021, 101(15): 1097-1101.
42. Hentze B, Muders T, Luepschen H, et al. Regional lung ventilation and perfusion by electrical impedance tomography compared to single-photon emission computed tomography. Physiol Meas, 2018, 39(6): 065004.

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