Electrical impedance tomography reveals pathophysiology of neonatal pneumothorax during NAVA
Kallio, Merja; Rahtu, Marika; van Kaam, Anton H.; Bayford, Richard; Rimensberger, Peter C.; Frerichs, Inéz (2020-05-24)
Kallio, M, Rahtu, M, van Kaam, AH, Bayford, R, Rimensberger, PC, Frerichs, I. Electrical impedance tomography reveals pathophysiology of neonatal pneumothorax during NAVA. Clin Case Rep. 2020; 8: 1574– 1578. https://doi.org/10.1002/ccr3.2944
© 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
https://creativecommons.org/licenses/by-nc-nd/4.0/
https://urn.fi/URN:NBN:fi-fe2020120499425
Tiivistelmä
Abstract
Pneumothorax is a potentially life‐threatening complication of neonatal respiratory distress syndrome (RDS). We describe a case of a tension pneumothorax that occurred during neurally adjusted ventilatory assist (NAVA) in a preterm infant suffering from RDS. The infant was included in a multicenter study examining the role of electrical impedance tomography (EIT) in intensive care and therefore continuously monitored with this imaging method. The attending physicians were blinded for EIT findings but offline analysis revealed the potential of EIT to clarify the underlying cause of this complication, which in this case was heterogeneous lung disease resulting in uneven ventilation distribution. Instantaneous increase in end‐expiratory lung impedance on the affected side was observed at time of the air leak. Real‐time bedside availability of EIT data could have modified the treatment decisions made.
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