Respiratory failure & ventilation
Bedside electrical impedance tomography in early diagnosis of pneumothorax in mechanically ventilated intensive care unit (ICU) patients — a single-center retrospective cohort study
Authors' conclusion
The ventilation defect in the ventral regions and a high HVVI on EIT were observed in mechanically ventilated patients with PTX, which should trigger further diagnostics to confirm it.
Study context
- Population
- Mechanically ventilated supine ICU patients who received electrical impedance tomography (EIT) examinations
- Participants
- 203 participants
- Exposure
- Pneumothorax (PTX) vs no PTX on bedside EIT
- PTXn = 25
- Outcome
- EIT ventilation defect score (DS) and horizontal ventral ventilation index (HVVI)
Methodological detailssingle-center
- Single-center
Main finding
As reported in the abstract
| Group | Value | Defect score (DS) dorsal quadrants, median (IQR) | Horizontal ventral ventilation index (HVVI), median (IQR) |
|---|---|---|---|
| PTX | median 1.00 (IQR 0.00–2.00) | 1.00 (0.00, 1.00) | 2.51 (1.58, 3.52) |
| non-PTX | median 0.00 (IQR 0.00–0.00) | 0.00 (0.00, 1.00) | 1.36 (1.15, 1.77) |
Value
PTXmedian 1.00 (IQR 0.00–2.00)
non-PTXmedian 0.00 (IQR 0.00–0.00)
Defect score (DS) dorsal quadrants, median (IQR)
PTX1.00 (0.00, 1.00)
non-PTX0.00 (0.00, 1.00)
Horizontal ventral ventilation index (HVVI), median (IQR)
PTX2.51 (1.58, 3.52)
non-PTX1.36 (1.15, 1.77)
- PTX vs non-PTX: P < 0.001 — DS ventral quadrants
- PTX vs non-PTX: P = 0.722 — DS dorsal quadrants, similar
- PTX vs non-PTX: P < 0.001 — HVVI higher in PTX
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Diagnostic accuracy of HVVI for PTX vs non-PTX | HVVI AUC 0.88 · sensitivity 70% · specificity 90% · cut-off 2.57 |
Cause of PTX
- Preceding cardiac surgery was the most common cause of PTX
Original publication
Bedside electrical impedance tomography in early diagnosis of pneumothorax in mechanically ventilated ICU patients — a single-center retrospective cohort study. J Clin Monit Comput. Published 4 November 2022. doi:10.
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