Automated Analysis of EIT Data for PEEP Setting

Study Overview
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Brief Summary
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First: to develop a computerized algorithm for automated analysis of the electrical impedance tomography (EIT) data. The algorithm calculates the optimal positive end-expiratory pressure (PEEP) and inspiratory pressure defined as the optimal balance between stretch, ventilation distribution and collapse. Second: to compare the results of the algorithm with the current standard of care clinical judgement of an experienced ventilation practitioner.

Detailed Description
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The study will be performed at the Intensive Care Unit, Maastricht University Medical Centre. The investigators routinely apply EIT (Pulmovista, Dräger, Lübeck. Germany) in mechanically ventilated patients to optimize the ventilator settings . An algorithm will be developed by the Institute of Technical Medicine, Furtwangen University, Germany. The algorithm will automatically detect changes in both PEEP and inspiratory pressures. For each PEEP step and/or changes in inspiratory pressure the difference in regional alveolar overdistension and alveolar collapse will be calculated. This makes it possible to select the optimal ventilator setting depending on the best compromise between alveolar overdistension and alveolar collapse. The algorithm will be tested in 40 EIT guided mechanically ventilated patients. EIT measurements will be performed during an incremental and decremental PEEP trial. The EIT measurement will be performed in the same way as during standard clinical care. EIT data will be analysed offline by a ventilation practitioner with experience in EIT and with the newly developed algorithm. The resulting advice on optimal ventilator settings will be compared for inter-observer variability.

Official Title
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Comparing the Results of a Computer Analysis Algorithm With Clinical Decisions in a Patient With Electrical Impedance Tomography Guided Ventilator Settings Regarding Optimal Positive End Expiratory Pressure and Inspiratory Pressure

Conditions
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Acute Hypoxemic Respiratory Failure, Post-cardiac Surgery

Intervention / Treatment
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* Other: computerized algorithm for automated analysis


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mechanically ventilated in a volume or pressure controlled mode ventilator settings guided by EIT Exclusion Criteria: Participants who specifically opt-out regarding the use of the data for research purpose Internal pacemaker, Implantable Cardioverter Defibrillator Skin lesions, dressings at the thorax, hindering belt placement Thoracic circumference < 70 cm Thoracic circumference > 150 cm BMI > 50

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: computerized algorithm for automated analysis|First: to develop a computerized algorithm for automated analysis of the electrical impedance tomography (EIT) data. The algorithm calculates the optimal positive end-expiratory pressure (PEEP) and inspiratory pressure defined as the optimal balance between stretch, ventilation distribution and collapse. Second: to compare the results of the algorithm with the current standard of care clinical judgement of experienced EIT users|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| develop automated EIT data algorithm for PEEP setting | The automated algorithm will give an advise on PEEP and delta pressure settings, based upon the EIT data, which is in accordance with the decision of the investigator | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PEEP, Electrical Impedance Tomography