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1.
Comput Biol Med ; 182: 109219, 2024 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-39362004

RESUMO

Breast cancer remains a leading cause of cancer mortality worldwide, with early detection crucial for improving outcomes. This systematic review evaluates recent advances in portable non-invasive technologies for early breast cancer detection, assessing their methods, performance, and potential for clinical implementation. A comprehensive literature search was conducted across major databases for relevant studies published between 2015 and 2024. Data on technology types, detection methods, and diagnostic performance were extracted and synthesized from 41 included studies. The review examined microwave imaging, electrical impedance tomography (EIT), thermography, bioimpedance spectroscopy (BIS), and pressure sensing technologies. Microwave imaging and EIT showed the most promise, with some studies reporting sensitivities and specificities over 90 %. However, most technologies are still in early stages of development with limited large-scale clinical validation. These innovations could complement existing gold standards, potentially improving screening rates and outcomes, especially in underserved populations, whiles decreasing screening waiting times in developed countries. Further research is therefore needed to validate their clinical efficacy, address implementation challenges, and assess their impact on patient outcomes before widespread adoption can be recommended.

2.
BJA Open ; 12: 100344, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39364288

RESUMO

Background: Prolonged mechanical ventilation can create heterogeneous ventilation patterns, which increase the risk of lung injury in infants. However, little is understood about the risk of brief exposure to mechanical ventilation during anaesthesia. The aim of this prospective observational study was to describe the regional pattern of lung ventilation during general anaesthesia in healthy neonates and infants, using electrical impedance tomography. Methods: Twenty infants (age 3 days to 12 months), without known lung disease and receiving general anaesthesia with endotracheal intubation for supine positioned surgery, were included in the study. Anaesthesia and ventilation management was at the discretion of the treating clinician. Standardised lung imaging using electrical impedance tomography was made at six time points during anaesthesia from induction to post-extubation. At each time point, the gravity-dependent and right-left lung centre of ventilation was calculated. Results: Tidal ventilation favoured the dorsal lung regions at induction, with a median (inter-quartile range) centre of ventilation (CoV) of 58.2 (53.9-59.3)%. After intubation, there was a redistribution of ventilation to the ventral lung, with the greatest change occurring early in surgery: CoV of 53.8 (52.3-55.2)%. After extubation, CoV returned to pre-intubation values: 56.5 (54.7-58)%. Across all time points, the pattern of ventilation favoured the right lung. Conclusions: General anaesthesia creates heterogenous patterns of ventilation similar to those reported during prolonged mechanical ventilation. This potentially poses a risk for lung injury that may not be recognised clinically. These results suggest the need to better understand the impact of general anaesthesia on the developing lung. Clinical trial registration: Australian New Zealand Clinical Trials Registry (ACTRN 12616000818437, 22 June 2016).

3.
ALTEX ; 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39228327

RESUMO

Currently, the OECD has adopted three defined approaches (DAs) for eye hazard identification of non-surfactant liquids and solids (TG467) according to the three UN GHS categories (Cat.1, Cat.2, No Cat.). We are now expanding the applicability domain with a new DA for chemicals having surfactant (SF) properties (DASF). It is based on a combination of RhCE test methods (OECD TG492: EpiOcular™ EIT or SkinEthic™ HCE EIT) and a modification of the Short Time Exposure (STE, TG491) method. The aim of the current study was to compare the performance of the DASF with the performance of other NAMs currently included in the OECD TGs and with the classification based on the Draize eye test to identify potential additional DAs. The minimum performance criteria (75% Cat.1, 50% Cat.2, 70% No Cat.) used for the adoption of the DAs currently included in OECD TG467 were used for this purpose. The DASF identified 90.9% of Cat. 1 (N=23), 77.8% of Cat. 2 (N=9) and 76.0% of No Cat. (N=17) surfactants, meeting the minimum performance criteria. Some of the NAMs that are currently included in the OECD TGs seem promising methods to be part of a DA to identify Cat. 1 or No Cat. for eye hazard assessment of surfactants. However, the number of surfactants that have been tested to evaluate reliability and relevance was often too small. To date, the DASF is the only DA that has evaluated a sufficiently large number of surfactants and whose performance met the OECD acceptance criteria.


Three non-animal-based defined approaches (DAs) for eye hazard assessment of non-surfactant liquid and solid chemicals were adopted as full replacements as OECD Test Guideline (TG 467). We now extend the applicability domain to surfactants with a new DA (DASF), which combines OECD-adopted test systems based on human 3D eye models and rabbit 2D corneal cells. The DASF has been shown to provide reliable results in predicting the eye irritation potential of 50 surfactants. The aim of the current study was to compare the performance of the DASF with the performance of other OECD TG new approach methodologies and compare it with the classification based on historical animal test data. Based on this analysis no additional DAs could be derived. Until today, the DASF is the best predicting, human-relevant DA that covers the whole range of eye irritation responses across the different surfactant classes.

4.
Sensors (Basel) ; 24(18)2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39338640

RESUMO

Bioimpedance imaging aims to generate a 3D map of the resistivity and permittivity of biological tissue from multiple impedance channels measured with electrodes applied to the skin. When the electrodes are distributed around the body (for example, by delineating a cross section of the chest or a limb), bioimpedance imaging is called electrical impedance tomography (EIT) and results in functional 2D images. Conventional EIT systems rely on individually cabling each electrode to master electronics in a star configuration. This approach works well for rack-mounted equipment; however, the bulkiness of the cabling is unsuitable for a wearable system. Previously presented cooperative sensors solve this cabling problem using active (dry) electrodes connected via a two-wire parallel bus. The bus can be implemented with two unshielded wires or even two conductive textile layers, thus replacing the cumbersome wiring of the conventional star arrangement. Prior research demonstrated cooperative sensors for measuring bioimpedances, successfully realizing a measurement reference signal, sensor synchronization, and data transfer though still relying on individual batteries to power the sensors. Subsequent research using cooperative sensors for biopotential measurements proposed a method to remove batteries from the sensors and have the central unit supply power over the two-wire bus. Building from our previous research, this paper presents the application of this method to the measurement of bioimpedances. Two different approaches are discussed, one using discrete, commercially available components, and the other with an application-specific integrated circuit (ASIC). The initial experimental results reveal that both approaches are feasible, but the ASIC approach offers advantages for medical safety, as well as lower power consumption and a smaller size.


Assuntos
Impedância Elétrica , Eletrodos , Dispositivos Eletrônicos Vestíveis , Humanos , Fontes de Energia Elétrica , Tomografia/instrumentação , Tomografia/métodos , Desenho de Equipamento , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodos
5.
Sci Rep ; 14(1): 18556, 2024 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-39122912

RESUMO

Highly efficient Metamaterials are necessary for applications in sensing, communication, etc. Fano resonance and electromagnetically induced transparency-like phenomena are essential for obtaining high Q-factor and sensitive Metamaterials. Employing both numerical simulations and experimental analysis, we investigate the emergence of Fano resonance in cross-resonator Metamaterials facilitated by the conductive coupling between dark and bright resonators. We analyze the gradual shift of the fano resonance by tuning the dark resonator and finally form an electromagnetically induced transparency-like transmission peak. The strong coupling of the resonator is observed in the form of an anti-crossing and discussed through analytical models. We demonstrate that the coupling strength of the dark and bright resonance in our metamaterial is proportional to the asymmetry parameter, albeit at the cost of the Fano resonance's Q-factor. The findings and methods introduced in this study can be used to develop highly efficient THz Metamaterials for various applications operable in room conditions.

6.
Crit Care ; 28(1): 241, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39010228

RESUMO

BACKGROUND: Assessment of regional ventilation/perfusion (V'/Q) mismatch using electrical impedance tomography (EIT) represents a promising advancement for personalized management of the acute respiratory distress syndrome (ARDS). However, accuracy is still hindered by the need for invasive monitoring to calibrate ventilation and perfusion. Here, we propose a non-invasive correction that uses only EIT data and characterized patients with more pronounced compensation of V'/Q mismatch. METHODS: We enrolled twenty-one ARDS patients on controlled mechanical ventilation. Cardiac output was measured invasively, and ventilation and perfusion were assessed by EIT. Relative V'/Q maps by EIT were calibrated to absolute values using the minute ventilation to invasive cardiac output (MV/CO) ratio (V'/Q-ABS), left unadjusted (V'/Q-REL), or corrected by MV/CO ratio derived from EIT data (V'/Q-CORR). The ratio between ventilation to dependent regions and perfusion reaching shunted units ( V D ' /QSHUNT) was calculated as an index of more effective hypoxic pulmonary vasoconstriction. The ratio between perfusion to non-dependent regions and ventilation to dead space units (QND/ V DS ' ) was calculated as an index of hypocapnic pneumoconstriction. RESULTS: Our calibration factor correlated with invasive MV/CO (r = 0.65, p < 0.001), showed good accuracy and no apparent bias. Compared to V'/Q-ABS, V'/Q-REL maps overestimated ventilation (p = 0.013) and perfusion (p = 0.002) to low V'/Q units and underestimated ventilation (p = 0.011) and perfusion (p = 0.008) to high V'/Q units. The heterogeneity of ventilation and perfusion reaching different V'/Q compartments was underestimated. V'/Q-CORR maps eliminated all these differences with V'/Q-ABS (p > 0.05). Higher V D ' / Q SHUNT correlated with higher PaO2/FiO2 (r = 0.49, p = 0.025) and lower shunt fraction (ρ = - 0.59, p = 0.005). Higher Q ND / V DS ' correlated with lower PEEP (ρ = - 0.62, p = 0.003) and plateau pressure (ρ = - 0.59, p = 0.005). Lower values of both indexes were associated with less ventilator-free days (p = 0.05 and p = 0.03, respectively). CONCLUSIONS: Regional V'/Q maps calibrated with a non-invasive EIT-only method closely approximate the ones obtained with invasive monitoring. Higher efficiency of shunt compensation improves oxygenation while compensation of dead space is less needed at lower airway pressure. Patients with more effective compensation mechanisms could have better outcomes.


Assuntos
Impedância Elétrica , Síndrome do Desconforto Respiratório , Tomografia , Relação Ventilação-Perfusão , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/fisiopatologia , Síndrome do Desconforto Respiratório/terapia , Impedância Elétrica/uso terapêutico , Idoso , Relação Ventilação-Perfusão/fisiologia , Tomografia/métodos , Espaço Morto Respiratório/fisiologia , Respiração Artificial/métodos , Adulto , Monitorização Fisiológica/métodos , Débito Cardíaco/fisiologia
7.
Physiol Meas ; 45(7)2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38959902

RESUMO

Objective.Electrical impedance tomography (EIT) has been used to determine regional lung ventilation distribution in humans for decades, however, the effect of biological sex on the findings has hardly ever been examined. The aim of our study was to determine if the spatial distribution of ventilation assessed by EIT during quiet breathing was influenced by biological sex.Approach.219 adults with no known acute or chronic lung disease were examined in sitting position with the EIT electrodes placed around the lower chest (6th intercostal space). EIT data were recorded at 33 images/s during quiet breathing for 60 s. Regional tidal impedance variation was calculated in all EIT image pixels and the spatial distribution of the values was determined using the established EIT measures of centre of ventilation in ventrodorsal (CoVvd) and right-to-left direction (CoVrl), the dorsal and right fraction of ventilation, and ventilation defect score.Main results.After exclusion of one subject due to insufficient electrode contact, 218 data sets were analysed (120 men, 98 women) (age: 53 ± 18 vs 50 ± 16 yr (p= 0.2607), body mass index: 26.4 ± 4.0 vs 26.4 ± 6.6 kg m-2(p= 0.9158), mean ± SD). Highly significant differences in ventilation distribution were identified between men and women between the right and left chest sides (CoVrl: 47.0 ± 2.9 vs 48.8 ± 3.3% of chest diameter (p< 0.0001), right fraction of ventilation: 0.573 ± 0.067 vs 0.539 ± 0.071 (p= 0.0004)) and less significant in the ventrodorsal direction (CoVvd: 55.6 ± 4.2 vs 54.5 ± 3.6% of chest diameter (p= 0.0364), dorsal fraction of ventilation: 0.650 ± 0.121 vs 0.625 ± 0.104 (p= 0.1155)). Ventilation defect score higher than one was found in 42.5% of men but only in 16.6% of women.Significance.Biological sex needs to be considered when EIT findings acquired in upright subjects in a rather caudal examination plane are interpreted. Sex differences in chest anatomy and thoracoabdominal mechanics may explain the results.


Assuntos
Impedância Elétrica , Caracteres Sexuais , Tórax , Tomografia , Humanos , Masculino , Feminino , Tomografia/métodos , Pessoa de Meia-Idade , Tórax/diagnóstico por imagem , Adulto
8.
J Pers Med ; 14(7)2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-39063931

RESUMO

BACKGROUND: Electrical Impedance Tomography (EIT), combined with variable ventilation strategies and Artificial Intelligence (AI), is poised to revolutionize critical care by transitioning from reactive to predictive approaches. This integration aims to enhance patient outcomes through personalized interventions and real-time monitoring. METHODS: this narrative review explores the principles and applications of EIT, variable ventilation, and AI in critical care. EIT impedance sensing creates dynamic images of internal physiology, aiding the management of conditions like Acute Respiratory Distress Syndrome (ARDS). Variable ventilation mimics natural breathing variability to improve lung function and minimize ventilator-induced lung injury. AI enhances EIT through advanced image reconstruction techniques, neural networks, and digital twin technology, offering more accurate diagnostics and tailored therapeutic interventions. CONCLUSIONS: the confluence of EIT, variable ventilation, and AI represents a significant advancement in critical care, enabling a predictive, personalized approach. EIT provides real-time insights into lung function, guiding precise ventilation adjustments and therapeutic interventions. AI integration enhances EIT diagnostic capabilities, facilitating the development of personalized treatment plans. This synergy fosters interdisciplinary collaborations and sets the stage for innovative research, ultimately improving patient outcomes and advancing the future of critical care.

9.
Physiol Meas ; 45(7)2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-38925138

RESUMO

Objective.In the future, thoracic electrical impedance tomography (EIT) monitoring may include continuous and simultaneous tracking of both breathing and heart activity. However, an effective way to decompose an EIT image stream into physiological processes as ventilation-related and cardiac-related signals is missing.Approach.This study analyses the potential ofMulti-dimensional Ensemble Empirical Mode Decompositionby application of theComplete Ensemble Empirical Mode Decomposition with Adaptive Noiseand a novel frequency-based combination criterion for detrending, denoising and source separation of EIT image streams, collected from nine healthy male test subjects with similar age and constitution.Main results.In this paper, a novel approach to estimate the lung, the heart and the perfused regions of an EIT image is proposed, which is based on theRoot Mean Square Errorbetween the index of maximal respiratory and cardiac variation to their surroundings. The summation of the indexes of the respective regions reveals physiologically meaningful time signals, separated into the physiological bandwidths of ventilation and heart activity at rest. Moreover, the respective regions were compared with the relative thorax movement and photoplethysmogram (PPG) signal. In linear regression analysis and in the Bland-Altman plot, the beat-to-beat time course of both the ventilation-related signal and the cardiac-related signal showed a high similarity with the respective reference signal.Significance.Analysis of the data reveals a fair separation of ventilatory and cardiac activity realizing the aimed source separation, with optional detrending and denoising. For all performed analyses, a feasible correlation of 0.587 to 0.905 was found between the cardiac-related signal and the PPG signal.


Assuntos
Impedância Elétrica , Tomografia , Humanos , Tomografia/métodos , Masculino , Adulto , Processamento de Imagem Assistida por Computador/métodos , Processamento de Sinais Assistido por Computador , Coração/fisiologia , Coração/diagnóstico por imagem , Perfusão , Respiração , Ventilação Pulmonar/fisiologia
10.
Sensors (Basel) ; 24(11)2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38894168

RESUMO

In medical imaging, detecting tissue anomalies is vital for accurate diagnosis and effective treatment. Electrical impedance tomography (EIT) is a non-invasive technique that monitors the changes in electrical conductivity within tissues in real time. However, the current challenge lies in simply and accurately reconstructing multi-conductivity distributions. This paper introduces a layered fusion framework for EIT to enhance imaging in multi-conductivity scenarios. The method begins with pre-imaging and extracts the main object from the fuzzy image to form one layer. Then, the voltage difference in the other layer, where the local anomaly is located, is estimated. Finally, the corresponding conductivity distribution is established, and multiple layers are fused to reconstruct the multi-conductivity distribution. The simulation and experimental results demonstrate that compared to traditional methods, the proposed method significantly improves multi-conductivity separation, precise anomaly localization, and robustness without adding uncertain parameters. Notably, the proposed method has demonstrated exceptional accuracy in local anomaly detection, with positional errors as low as 1% and size errors as low as 33%, which significantly outperforms the traditional method with respective minimum errors of 9% and 228%. This method ensures a balance between the simplicity and accuracy of the algorithm. At the same time, it breaks the constraints of traditional linear methods, struggling to identify multi-conductivity distributions, thereby providing new perspectives for clinical EIT.

11.
J Clin Monit Comput ; 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38758403

RESUMO

To determine how percutaneous tracheostomy (PT) impacts on respiratory system compliance (Crs) and end-expiratory lung volume (EELV) during volume control ventilation and to test whether a recruitment maneuver (RM) at the end of PT may reverse lung derecruitment. This is a single center, prospective, applied physiology study. 25 patients with acute brain injury who underwent PT were studied. Patients were ventilated in volume control ventilation. Electrical impedance tomography (EIT) monitoring and respiratory mechanics measurements were performed in three steps: (a) baseline, (b) after PT, and (c) after a standardized RM (10 sighs of 30 cmH2O lasting 3 s each within 1 min). End-expiratory lung impedance (EELI) was used as a surrogate of EELV. PT determined a significant EELI loss (mean reduction of 432 arbitrary units p = 0.049) leading to a reduction in Crs (55 ± 13 vs. 62 ± 13 mL/cmH2O; p < 0.001) as compared to baseline. RM was able to revert EELI loss and restore Crs (68 ± 15 vs. 55 ± 13 mL/cmH2O; p < 0.001). In a subgroup of patients (N = 8, 31%), we observed a gradual but progressive increase in EELI. In this subgroup, patients did not experience a decrease of Crs after PT as compared to patients without dynamic inflation. Dynamic inflation did not cause hemodynamic impairment nor raising of intracranial pressure. We propose a novel and explorative hyperinflation risk index (HRI) formula. Volume control ventilation did not prevent the PT-induced lung derecruitment. RM could restore the baseline lung volume and mechanics. Dynamic inflation is common during PT, it can be monitored real-time by EIT and anticipated by HRI. The presence of dynamic inflation during PT may prevent lung derecruitment.

12.
J Thorac Dis ; 16(3): 2070-2081, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38617762

RESUMO

Background: Electrical impedance tomography (EIT) is a relatively recent functional imaging technique that is both noninvasive and radiation free. EIT measures the associated voltage when a weak current is applied to the surface of the human body to determine the distribution of electrical resistance within tissues. We performed a bibliometrics-based review to explore the geographic hotspots of current research and future trends developing in the field of EIT for mechanical ventilation. Methods: The Web of Science database was searched from its inception to June 25, 2023. CiteSpace software was used to visualize and analyze the relevant literature and identify the most impactful literature, trends, and hotspots. Results: 363 articles describing EIT use in mechanical ventilation were identified. A fluctuating growth in the number of publications was observed from 1998 to 2023. Germany had the highest number of articles (n=154), followed by Italy (n=53) and China (n=52). A cluster analysis of keyword co-occurrence revealed that "titration", "ventilator-related lung injury", and "oxygenation" were the most actively researched terms associated with the use of EIT in mechanically ventilated patients. Conclusions: Significant progress has been made in EIT research for mechanical ventilation. EIT research is limited to a small number of countries with a present research focus on the prevention and treatment of ventilator-related lung injury, oxygenation status, and prone ventilation. These topics are expected to remain research hotspots in the future.

13.
PeerJ Comput Sci ; 10: e1944, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38660147

RESUMO

Electrical impedance tomography (EIT) provides an indirect measure of the physiological state and growth of the maize ear by reconstructing the distribution of electrical impedance. However, the two-dimensional (2D) EIT within the electrode plane finds it challenging to comprehensively represent the spatial distribution of conductivity of the intact maize ear, including the husk, kernels, and cob. Therefore, an effective method for 3D conductivity reconstruction is necessary. In practical applications, fluctuations in the contact impedance of the maize ear occur, particularly with the increase in the number of grids and computational workload during the reconstruction of 3D spatial conductivity. These fluctuations may accentuate the ill-conditioning and nonlinearity of the EIT. To address these challenges, we introduce RFNetEIT, a novel computational framework specifically tailored for the absolute imaging of the three-dimensional electrical impedance of maize ear. This strategy transforms the reconstruction of 3D electrical conductivity into a regression process. Initially, a feature map is extracted from measured boundary voltage via a data reconstruction module, thereby enhancing the correlation among different dimensions. Subsequently, a nonlinear mapping model of the 3D spatial distribution of the boundary voltage and conductivity is established, utilizing the residual network. The performance of the proposed framework is assessed through numerical simulation experiments, acrylic model experiments, and maize ear experiments. Our experimental results indicate that our method yields superior reconstruction performance in terms of root-mean-square error (RMSE), correlation coefficient (CC), structural similarity index (SSIM), and inverse problem-solving time (IPST). Furthermore, the reconstruction experiments on maize ears demonstrate that the method can effectively reconstruct the 3D conductivity distribution.

14.
J Clin Monit Comput ; 38(4): 873-883, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38619718

RESUMO

Electrical Impedance Tomography (EIT) is a novel real-time lung imaging technology for personalized ventilation adjustments, indicating promising results in animals and humans. The present study aimed to assess its clinical utility for improved ventilation and oxygenation compared to traditional protocols. Comprehensive electronic database screening was done until 30th November, 2023. Randomized controlled trials, controlled clinical trials, comparative cohort studies, and assessments of EIT-guided PEEP titration and conventional methods in adult ARDS patients regarding outcome, ventilatory parameters, and P/F ratio were included. Our search retrieved five controlled cohort studies and two RCTs with 515 patients and overall reduced risk of mortality [RR = 0.68; 95% CI: 0.49 to 0.95; I2 = 0%], better dynamic compliance [MD = 3.46; 95% CI: 1.59 to 5.34; I2 = 0%] with no significant difference in PaO2/FiO2 ratio [MD = 6.5; 95%CI -13.86 to 26.76; I2 = 74%]. The required information size except PaO2/FiO2 was achieved for a power of 95% based on the 50% reduction in risk of mortality, 10% improved compliance as the cumulative Z-score of the said outcomes crossed the alpha spending boundary and did not dip below the inner wedge of futility. EIT-guided individualized PEEP titration is a novel modality; further well-designed studies are needed to substantiate its utility.


Assuntos
Impedância Elétrica , Pulmão , Respiração com Pressão Positiva , Síndrome do Desconforto Respiratório , Tomografia , Respiração com Pressão Positiva/métodos , Humanos , Síndrome do Desconforto Respiratório/terapia , Síndrome do Desconforto Respiratório/mortalidade , Tomografia/métodos , Pulmão/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Respir Res ; 25(1): 179, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664685

RESUMO

BACKGROUND: Prolonged weaning from mechanical ventilation is associated with poor clinical outcome. Therefore, choosing the right moment for weaning and extubation is essential. Electrical Impedance Tomography (EIT) is a promising innovative lung monitoring technique, but its role in supporting weaning decisions is yet uncertain. We aimed to evaluate physiological trends during a T-piece spontaneous breathing trail (SBT) as measured with EIT and the relation between EIT parameters and SBT success or failure. METHODS: This is an observational study in which twenty-four adult patients receiving mechanical ventilation performed an SBT. EIT monitoring was performed around the SBT. Multiple EIT parameters including the end-expiratory lung impedance (EELI), delta Tidal Impedance (ΔZ), Global Inhomogeneity index (GI), Rapid Shallow Breathing Index (RSBIEIT), Respiratory Rate (RREIT) and Minute Ventilation (MVEIT) were computed on a breath-by-breath basis from stable tidal breathing periods. RESULTS: EELI values dropped after the start of the SBT (p < 0.001) and did not recover to baseline after restarting mechanical ventilation. The ΔZ dropped (p < 0.001) but restored to baseline within seconds after restarting mechanical ventilation. Five patients failed the SBT, the GI (p = 0.01) and transcutaneous CO2 (p < 0.001) values significantly increased during the SBT in patients who failed the SBT compared to patients with a successful SBT. CONCLUSION: EIT has the potential to assess changes in ventilation distribution and quantify the inhomogeneity of the lungs during the SBT. High lung inhomogeneity was found during SBT failure. Insight into physiological trends for the individual patient can be obtained with EIT during weaning from mechanical ventilation, but its role in predicting weaning failure requires further study.


Assuntos
Impedância Elétrica , Tomografia , Desmame do Respirador , Humanos , Desmame do Respirador/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Tomografia/métodos , Monitorização Fisiológica/métodos , Adulto , Respiração Artificial/métodos , Respiração , Idoso de 80 Anos ou mais , Pulmão/fisiopatologia , Pulmão/diagnóstico por imagem , Pulmão/fisiologia
16.
Crit Care ; 28(1): 124, 2024 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627745

RESUMO

Extracorporeal Carbon Dioxide Removal (ECCO2R) is used in acute respiratory distress syndrome (ARDS) patients to facilitate lung-protective ventilatory strategies. Electrical Impedance Tomography (EIT) allows individual, non-invasive, real-time, bedside, radiation-free imaging of the lungs, providing global and regional dynamic lung analyses. To provide new insights for future ECCO2R research in ARDS, we propose a potential application of EIT to personalize End-Expiratory Pressure (PEEP) following each reduction in tidal volume (VT), as demonstrated in an illustrative case. A 72-year-old male with COVID-19 was admitted to the ICU for moderate ARDS. Monitoring with EIT was started to determine the optimal PEEP value (PEEPEIT), defined as the intersection of the collapse and overdistention curves, after each reduction in VT during ECCO2R. The identified PEEPEIT values were notably low (< 10 cmH2O). The decrease in VT associated with PEEPEIT levels resulted in improved lung compliance, reduced driving pressure and a more uniform ventilation pattern. Despite current Randomized Controlled Trials showing that ultra-protective ventilation with ECCO2R does not improve survival, the applicability of universal ultra-protective ventilation settings for all patients remains a subject of debate. Inappropriately set PEEP levels can lead to alveolar collapse or overdistension, potentially negating the benefits of VT reduction. EIT facilitates real-time monitoring of derecruitment associated with VT reduction, guiding physicians in determining the optimal PEEP value after each decrease in tidal volume. This original description of using EIT under ECCO2R to adjust PEEP at a level compromising between recruitability and overdistention could be a crucial element for future research on ECCO2R.


Assuntos
Respiração com Pressão Positiva , Síndrome do Desconforto Respiratório , Masculino , Humanos , Idoso , Impedância Elétrica , Respiração com Pressão Positiva/métodos , Pulmão , Tomografia Computadorizada por Raios X , Síndrome do Desconforto Respiratório/terapia , Volume de Ventilação Pulmonar , Tomografia/métodos
17.
Materials (Basel) ; 17(6)2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38541446

RESUMO

Coupling is a ubiquitous phenomenon observed in various systems, which profoundly alters the original oscillation state of resonant systems and leads to the unique optical properties of metasurfaces. In this study, we introduce a terahertz (THz) tunable coupling metasurface characterized by a four-fold rotation (C4) symmetry-breaking structural array achieved through the incorporation of vanadium dioxide (VO2). This disruption of the C4 symmetry results in dynamically controlled electromagnetic interactions and couplings between excitation modes. The coupling between new resonant modes modifies the peak of electromagnetic-induced transparency (EIT) within the C4 symmetric metasurfaces, simulating the mutual interference process between modes. Additionally, breaking the C4 symmetry enhances the mirror asymmetry, and imparts distinct chiral properties in the far-field during the experimental process. This research demonstrates promising applications in diverse fields, including biological monitoring, light modulation, sensing, and nonlinear enhancement.

18.
HardwareX ; 18: e00521, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38549955

RESUMO

Electrical impedance tomography (EIT) is medical imaging technique in which small electrical signals are used to map the electrical impedance distribution within the body. It is safe and non-invasive, which make it attractive for use in continuous monitoring or outpatient applications, but the high cost of commercial devices is an impediment to its adoption. Over the last 10 years, many research groups have developed their own EIT devices, but few designs for open-source EIT hardware are available. In this work, we present a complete open-source EIT system that is designed to be suitable for monitoring the lungs of free breathing subjects. The device is low-cost, wearable, and is designed to comply with the industry accepted safety standard for EIT. The device has been tested in two regimes: Firstly in terms of measurement uncertainty as a voltage measurement system, and secondly against a set of measures that have been proposed specifically for EIT hardware. The voltage measurement uncertainty of the device was measured to be - 0.7 % ± 0.36 mV. The EIT specific performance was measured in a phantom test designed to be as physiologically representative as practicable, and the device performed similarly to other published devices. This work will contribute to increased accessibility of EIT for study and will contribute to consensus on testing methodology for EIT devices.

19.
Appl Radiat Isot ; 208: 111253, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38493564

RESUMO

In this study, the effect of high γ-doses on the track parameters, structure as well as optical properties of pristine and γ-irradiation CR-39 nuclear track detector (NTD) were investigated. CR-39 detectors were exposed to γ-doses from 50 up to 500 kGy and then irradiated by fission ions (F.F) of fluence from 252CF source. The track diameter (D), bulk etch rate (VB), etch induction time (EIT), cut-off or saturated time (tcut-off) for saturated diameters and projected track length (Lo) of normally and inclined incident fission tracks were estimated for different removal layers (h). A linear relationship between D and γ-doses (Dγ) up to 500 k Gy was obtained. The VB for pristine and for γ-irradiated CR-39 was determined. A linear behaviour of VB was obtained up to 300 kGy. Etch induction time (EIT) and saturated time (tcut-off) of pristine and γ-irradiated detectors for normal and inclined fission ions tracks were evaluated respectively up to 500 kGy. Each EIT and tcut-off decreased exponentially fast with increasing γ-doses but the inclined incidence appeared earlier than normal case. Pristine and γ-irradiated CR-39 detectors were examined using FTIR and UV-Vis spectrophotometer. From this study, a linear relation of band gap energies (Egap) as a function of γ-doses, Dγ, was obtained. The value of (Egap) decreased when increasing γ-doses for direct and indirect transitions, respectively. In addition, a systematic increase of Urbach energy (EU) was recorded together with the Dγ increase. Moreover, a linear behavior of the refractive index (n) along with γ-irradiated CR-39 plastic detector was observed via direct and indirect methods.

20.
Sensors (Basel) ; 24(2)2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38257426

RESUMO

This paper introduces a sensitivity matrix decomposition regularization (SMDR) method for electric impedance tomography (EIT). Using k-means clustering, the EIT-reconstructed image can be divided into four clusters, derived based on image features, representing posterior information. The sensitivity matrix is then decomposed into distinct work areas based on these clusters. The elimination of smooth edge effects is achieved through differentiation of the images from the decomposed sensitivity matrix and further post-processing reliant on image features. The algorithm ensures low computational complexity and avoids introducing extra parameters. Numerical simulations and experimental data verification highlight the effectiveness of SMDR. The proposed SMDR algorithm demonstrates higher accuracy and robustness compared to the typical Tikhonov regularization and the iterative penalty term-based regularization method (with an improvement of up to 0.1156 in correlation coefficient). Moreover, SMDR achieves a harmonious balance between image fidelity and sparsity, effectively addressing practical application requirements.

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