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  • Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group

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State of the art review
Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group
  1. Inéz Frerichs1,
  2. Marcelo B P Amato2,
  3. Anton H van Kaam3,
  4. David G Tingay4,
  5. Zhanqi Zhao5,
  6. Bartłomiej Grychtol6,
  7. Marc Bodenstein7,
  8. Hervé Gagnon8,
  9. Stephan H Böhm9,
  10. Eckhard Teschner10,
  11. Ola Stenqvist11,
  12. Tommaso Mauri12,
  13. Vinicius Torsani2,
  14. Luigi Camporota13,
  15. Andreas Schibler14,
  16. Gerhard K Wolf15,
  17. Diederik Gommers16,
  18. Steffen Leonhardt17,
  19. Andy Adler8,
  20. TREND study group
    1. 1Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
    2. 2Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
    3. 3Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
    4. 4Neonatal Research, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
    5. 5Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
    6. 6Fraunhofer Project Group for Automation in Medicine and Biotechnology PAMB, Mannheim, Germany
    7. 7Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
    8. 8Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
    9. 9Swisstom AG, Landquart, Switzerland
    10. 10Dräger Medical GmbH, Lübeck, Germany
    11. 11Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
    12. 12Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
    13. 13Department of Adult Critical Care, Guy's and St Thomas’ NHS Foundation Trust, London, UK
    14. 14Paediatric Critical Care Research Group, Mater Research University of Queensland, South Brisbane, Australia
    15. 15Children's Hospital Traunstein, Ludwig Maximilian's University, Munich, Germany
    16. 16Department of Adult Intensive Care, Erasmus MC, Rotterdam, The Netherlands
    17. 17Philips Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
    1. Correspondence to Professor Dr Inéz Frerichs, Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Kiel 24105, Germany; frerichs{at}anaesthesie.uni-kiel.de

    Abstract

    Electrical impedance tomography (EIT) has undergone 30 years of development. Functional chest examinations with this technology are considered clinically relevant, especially for monitoring regional lung ventilation in mechanically ventilated patients and for regional pulmonary function testing in patients with chronic lung diseases. As EIT becomes an established medical technology, it requires consensus examination, nomenclature, data analysis and interpretation schemes. Such consensus is needed to compare, understand and reproduce study findings from and among different research groups, to enable large clinical trials and, ultimately, routine clinical use. Recommendations of how EIT findings can be applied to generate diagnoses and impact clinical decision-making and therapy planning are required. This consensus paper was prepared by an international working group, collaborating on the clinical promotion of EIT called TRanslational EIT developmeNt stuDy group. It addresses the stated needs by providing (1) a new classification of core processes involved in chest EIT examinations and data analysis, (2) focus on clinical applications with structured reviews and outlooks (separately for adult and neonatal/paediatric patients), (3) a structured framework to categorise and understand the relationships among analysis approaches and their clinical roles, (4) consensus, unified terminology with clinical user-friendly definitions and explanations, (5) a review of all major work in thoracic EIT and (6) recommendations for future development (193 pages of online supplements systematically linked with the chief sections of the main document). We expect this information to be useful for clinicians and researchers working with EIT, as well as for industry producers of this technology.

    • ARDS
    • Paediatric Lung Disaese
    • Assisted Ventilation
    • Imaging/CT MRI etc

    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

    https://doi.org/10.1136/thoraxjnl-2016-208357

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      Supplementary materials

      Footnotes

      • Collaborators TRanslational EIT developmeNt study (TREND) group: Eddy Fan; William RB Lionheart; Thomas Riedel; Peter C Rimensberger; Fernando Suarez Sipmann; Norbert Weiler and Hermann Wrigge.

      • Contributors Writing: IF, AA, MBPA, AHvK, DGT, ZZ, BG, MB, HG, SHB and ET with input from OS, TM, VT, LC, AS, GKW, DG and SL. Revising and approval of the manuscript: all authors and collaborators of the TREND study group.

      • Competing interests IF: Grants from The European Union's 7th Framework Programme for Research and Technological Development (WELCOME, Grant No. 611223) and from The European Union's Framework Programme for Research and Innovation Horizon 2020 (CRADL, Grant No. 668259), personal fees from Dräger, outside the submitted work. MBPA: Grants from Dixtal/Philips and Timpel SA, outside the submitted work. AHvK: non-financial support from CareFusion, outside the submitted work. DGT: Goe-MF II EIT system provided by CareFusion for unrestricted research use, two Swisstom Pioneer EIT systems and consumables fully purchased from the manufacturer, unrestricted assistance in customising research software for specific research needs by Swisstom. ZZ: Grant from the German Federal Ministry of Education and Research (MOSES, Grant No. 03FH038I3), personal fees from Dräger Medical, outside the submitted work. BG: Personal fees from Swisstom, outside the submitted work. SHB: Co-founder, employee and Chief Medical Officer of Swisstom AG, inventor of several EIT-related patents and patent applications owned by Swisstom AG and Timpel SA. ET: Employee of Dräger; several EIT-related patents pending and issued to Dräger. OS: Personal fees and non-financial support from Dräger Medical, outside the submitted work; owner of an issued patent EP 228009A1. VT: Personal fees from Timpel, outside the submitted work. DG: Personal fees from Dräger Medical, outside the submitted work. SL: Grants, personal fees and non-financial support from Dräger Medical, grants and non-financial support from Philips Research, grants and non-financial support from BMBF (private/public partnership project with Weinmann GmbH), grants and non-financial support from BMWi (public/private partnership ZIM project with Fritz Stephan GmbH), outside the submitted work; several patents pending, licensed and issued to Dräger Medical AG & Co KGaA.

      • Provenance and peer review Not commissioned; externally peer reviewed.