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Education  |   September 2018
Electrical Impedance Tomography for Confirmation of Lung Isolation during One-lung Ventilation
Author Notes
  • From the Department of Anesthesiology and Intensive Care Medicine (G.H., H.Wrigge) and the Department of Pulmonary Medicine (G.S., H.Wirtz), University of Leipzig, Leipzig, Germany.
  • Charles D. Collard, M.D., served as Handling Editor for this article. G.H. and G.S. contributed equally to this article.
    Charles D. Collard, M.D., served as Handling Editor for this article. G.H. and G.S. contributed equally to this article.×
  • Corrected on April 4, 2018.
    Corrected on April 4, 2018.×
  • Address correspondence to Dr. Wrigge: hermann.wrigge@medizin.uni-leipzig.de
Article Information
Education / Images in Anesthesiology / Thoracic Anesthesia
Education   |   September 2018
Electrical Impedance Tomography for Confirmation of Lung Isolation during One-lung Ventilation
Anesthesiology 9 2018, Vol.129, 580. doi:10.1097/ALN.0000000000002189
Anesthesiology 9 2018, Vol.129, 580. doi:10.1097/ALN.0000000000002189
One-lung ventilation is regularly performed to facilitate thoracic surgical procedures during general anesthesia. The adequacy of one-lung ventilation following placement of a double-lumen endotracheal tube was verified by auscultation and intermittent fiberoptic bronchoscopy. In addition, we continuously monitored one-lung ventilation by electrical impedance tomography,1  which is a noninvasive, radiation-free bedside method that continuously displays regional distribution of ventilation and may help to optimize ventilation during general anesthesia.2  Electrical impedance tomography measurements require a belt with electrodes around the patient’s chest (top image). In brief, axial images are reconstructed from impedance changes induced by very small alternating electrical currents, that are applied through pairs of electrodes.
Images A–D show thoracic electrical impedance tomography images. The blue shapes show summarized tidal changes due to ventilation and the dots are a schematic representation of the electrodes surrounding the thorax.
Image A shows electrical impedance tomography during deep spontaneous breathing with ventilation throughout both lungs. Image B illustrates the ventral shift of ventilation in both lungs with collapse of dependent lung areas, during manual ventilation after induction of anesthesia.3  Image C confirms correct lung separation by lack of ventilation signals of the left lung. Finally, image D shows ventilation of both lungs following resumption of spontaneous breathing after discontinuing anesthesia. Electrical impedance tomography may be a helpful monitoring tool during one-lung ventilation.
Competing Interests
Dr. Wrigge received consultancy fees from Dräger Medical, Lübeck, Germany; funding and lecture fees from InfectoPharm, Heppenheim, Germany; and lecture fees from MSD, Konstanz, Germany. The other authors declare no competing interests.
References
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