{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:18:02Z","timestamp":1772324282630,"version":"3.50.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>Lung-protective mechanical ventilation aims to prevent alveolar collapse and overdistension, but reliable bedside methods to quantify them are lacking. We propose a quantitative descriptor of the shape of local pressure-volume curves derived from electrical impedance tomography, for computing maps that highlight the presence and location of regions of presumed tidal recruitment (i.e., elastance decrease during inflation, pressure-volume curve with upward curvature) or overdistension (i.e., elastance increase during inflation, downward curvature).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Secondary analysis of experimental cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>University research facility.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Subjects:<\/jats:title>\n            <jats:p>Twelve mechanically ventilated pigs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Interventions:<\/jats:title>\n            <jats:p>After induction of acute respiratory distress syndrome by hydrochloric acid instillation, animals underwent a decremental positive end-expiratory pressure titration (steps of 2\u2009cm H<jats:sub>2<\/jats:sub>O starting from \u2265 26\u2009cm H<jats:sub>2<\/jats:sub>O).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Measurements and Main Results:<\/jats:title>\n            <jats:p>Electrical impedance tomography-derived maps were computed at each positive end-expiratory pressure-titration step, and whole-lung CT taken every second steps. Airway flow and pressure were recorded to compute driving pressure and elastance. Significant correlations between electrical impedance tomography-derived maps and positive end-expiratory pressure indicate that, expectedly, tidal recruitment increases in dependent regions with decreasing positive end-expiratory pressure (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001) and suggest that overdistension increases both at high and low positive end-expiratory pressures in nondependent regions (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.027), supporting the idea of two different scenarios of overdistension occurrence. Significant correlations with CT measurements were observed: electrical impedance tomography-derived tidal recruitment with poorly aerated regions (<jats:italic toggle=\"yes\">r<\/jats:italic> = 0.43; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001); electrical impedance tomography-derived overdistension with nonaerated regions at lower positive end-expiratory pressures and with hyperaerated regions at higher positive end-expiratory pressures (<jats:italic toggle=\"yes\">r<\/jats:italic> \u2265 0.72; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.003). Even for positive end-expiratory pressure levels minimizing global elastance and driving pressure, electrical impedance tomography-derived maps showed nonnegligible regions of presumed overdistension and tidal recruitment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Electrical impedance tomography-derived maps of pressure-volume curve shapes allow to detect regions in which elastance changes during inflation. This could promote individualized mechanical ventilation by minimizing the probability of local tidal recruitment and\/or overdistension. Electrical impedance tomography-derived maps might become clinically feasible and relevant, being simpler than currently available alternative approaches.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ccm.0000000000002233","type":"journal-article","created":{"date-parts":[[2017,1,11]],"date-time":"2017-01-11T23:17:19Z","timestamp":1484176639000},"page":"679-686","source":"Crossref","is-referenced-by-count":24,"title":["Mapping Regional Differences of Local Pressure-Volume Curves With Electrical Impedance Tomography"],"prefix":"10.1097","volume":"45","author":[{"given":"Alessandro","family":"Beda","sequence":"first","affiliation":[{"name":"Department of Electronic Engineering, BioSiX\u2014Biomedical Signal Processing, Analysis and Simulation Group, Postgraduate Program of Electrical Engineering (PPGEE), Federal University of Minas Gerais, Belo Horizonte, Brazil."}]},{"given":"Alysson R.","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"Nadja C.","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"S\u00f6ren","family":"Hammerm\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany."}]},{"given":"Marcelo B. P.","family":"Amato","sequence":"additional","affiliation":[{"name":"Pulmonary Division, Cardio-Pulmonary Department, Heart Institute (InCor), University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}]},{"given":"Thomas","family":"Muders","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany."}]},{"given":"Claudia","family":"Gittel","sequence":"additional","affiliation":[{"name":"Large Animal Clinic for Surgery, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany."}]},{"given":"Katharina","family":"Noreikat","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany."}]},{"given":"Hermann","family":"Wrigge","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany."}]},{"given":"Andreas 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