Assessment of regional lung mechanics with electrical impedance tomography can determine the requirement for ECMO in patients with severe ARDS.

摘要

Patients with severe acute respiratory distress syndrome (ARDS) may require extracorporeal oxygenation (ECMO) as a rescue treatment of refractory hypoxaemia. However, it remains unclear how mechanical ventilation can be optimised to reverse hypoxaemia and maximise lung protection in patients considered for or receiving ECMO [1]. In particular, mechanical ventilation during ECMO [2] may lead to over-distension and under-recruitment, depending on the degree of heterogeneity of regional compliances [3-5].We wish to describe-using two illustrative cases of patients with severe ARDS with a similar Lung Injury Score, referred to our institution for ECMO-how assessment of regional changes in compliance using electrical impedance tomography (EIT) may assist in the ventilatory strategy prior to or during ECMO.