Dataset Information

Real-Time Identification of Upper Airway Occlusion Using Electrical Impedance Tomography.

ABSTRACT:

Study objectives

Real-time monitoring of upper airway collapse during sleep could be instrumental for studies in biomechanics of obstructive sleep apnea (OSA) and selecting individualized treatment modalities. Although some imaging techniques are used under sedated sleep, none are available during the entire natural sleep process. We hypothesized that electrical impedance tomography (EIT) can be used for noninvasive continuous imaging of the upper airway during natural sleep and quantifying upper airway collapse in terms of its size.

Methods

After determining surface landmarks to attach the electrodes for monitoring the retroglossal airway, EIT was conducted in 10 healthy participants. As a feasibility test of EIT in detecting upper airway collapse, transient airway closure was induced by the swallowing maneuver. These EIT images were confirmed by simultaneous magnetic resonance imaging (MRI) scans. Subsequently, EIT scans were conducted in 7 healthy participants and 10 patients with OSA under nonsedated sleep to determine whether it could identify upper airway narrowing or collapse. Respiratory events were identified by concurrent polysomnography (PSG).

Results

Swallowing-induced airway closure was identified successfully in all 10 participants on simultaneous EIT and MRI scans. Sizes and positions of the upper airway closures in reconstructed EIT images were well correlated with those in magnetic resonance images. Obstructive hypopnea and apnea were detected successfully by EIT in 10 patients with OSA, and no significant changes in EIT data were observed in 7 healthy participants during concurrent EIT and PSG tests. Additionally, conductivity changes in the airway were greater during obstructive apnea than during hypopnea (64.3% versus 26.3%, respectively; P < .001) compared with those during baseline respiration.

Conclusions

EIT could be a useful real-time monitoring device for detecting upper airway narrowing or collapse during natural sleep in patients with OSA. Currently, changes in the upper airway size can be estimated with good accuracy, but shape estimation needs future improvements in the EIT image quality.

SUBMITTER: Kim YE

PROVIDER: S-EPMC6457513 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Real-Time Identification of Upper Airway Occlusion Using Electrical Impedance Tomography.

Kim Young Eun YE Woo Eung Je EJ Oh Tong In TI Kim Sang-Wook SW

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 20190415 4

<h4>Study objectives</h4>Real-time monitoring of upper airway collapse during sleep could be instrumental for studies in biomechanics of obstructive sleep apnea (OSA) and selecting individualized treatment modalities. Although some imaging techniques are used under sedated sleep, none are available during the entire natural sleep process. We hypothesized that electrical impedance tomography (EIT) can be used for noninvasive continuous imaging of the upper airway during natural sleep and quantify ...[more]

PMID: 30952215

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Project description:BackgroundAnimal trials contribute to major achievements in medical science. The so-called lavage model is frequently used to evaluate ventilation strategies in acute respiratory distress syndrome (ARDS) using electrical impedance tomography (EIT). But, the lavage model itself might have systematic impacts on EIT parameters. Therefore, we established an additional experimental model, in which ARDS is caused by intravenously administered lipopolysaccharide (LPS). In this study, we want to examine if EIT measurements provide consistent results in both experimental models or whether the pathophysiology of the model influences the findings. Overall, we want to compare both experimental models regarding clinical parameters and EIT-derived indices, namely the global inhomogeneity (GI) index and the regional ventilation delay (RVD) index.MethodsNineteen pigs were included in this study, allocated to the control group (CO; n = 5), lavage group (LAV; n = 7) and LPS group (LPS; n = 7). After baseline measurements and the establishment of ARDS, assessment of respiratory mechanics, hemodynamics, gas exchange and EIT recordings were performed hourly over eight hours.ResultsIn both experimental ARDS models, EIT measurements provided reliable results. But, the GI and the RVD index did not show consistent results as compared to the CO group. Initially, GI and RVD index were higher in the LAV group but not in the LPS group as compared to the CO group. This effect disappeared during the study. Furthermore, the GI index and the RVD index were higher in the LAV group compared to the LPS group in the beginning as well. This, once again, disappeared. Clinical lung injury parameters remained more stable when using LPS.ConclusionThe two models showed quite different influences on the GI and RVD index. This implies, that the underlying pathophysiology affects EIT parameters and thus the findings. Hence, translation to EIT-guided clinical therapy in humans suffering from ARDS might be limited.

Dataset Information

Real-Time Identification of Upper Airway Occlusion Using Electrical Impedance Tomography.

Study objectives

Methods

Results

Conclusions

Publications

Real-Time Identification of Upper Airway Occlusion Using Electrical Impedance Tomography.

Similar Datasets

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