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Serbian Journal of Anesthesia and Intensive Therapy
2017, vol. 39, br. 5-6, str. 149-157
jezik rada: srpski
vrsta rada: pregledni članak
doi:10.5937/sjait1706149V

Creative Commons License 4.0
Električna impedansna tomografija - novi monitoring regionalne distribucije ventilacije pluća (princip rada i klinička primena)
Klinika za anesteziologiju i intenzivnu terapiju, Vojnomedicinska Akademija, Beograd

e-adresa: radvuk@gmail.com

Sažetak

Električna impedansna tomografija (EIT) je ubrzo posle otkrića, osamdesetih godina prošlog veka, postala predmet interesovanja u medicini, pre svega zbog mogućnosti primene ove tehnologije u dijagnostici i monitoringu fizioloških funkcija. EIT je neinvazivna procedura, bez dodatnog štetnog zračenja. Podrazumeva monitoring regionalne distribucije ventilacije kontinuirano. Navedena karakteristika je i osnovna razlika između EIT i kompjuterizovane tomografije i drugih dijagnostičkih procedura, koje omogućavaju prikaz respiratornog sistema i njegove funkcije samo u trenutku snimanja (jednokratno). Pored toga, EIT omogućava kontinuiranu vizuelizaciju funkcije pluća pored pacijenta, što omogućava odmah dostupnu procenu efekata respiratornih terapijskih manevara. Rezultati dobijeni EIT-om su komplementarni sa rezultatima svih ostalih plućnih dijagnostičkih procedura, pre svega radioloških. U suštini, EIT upotpunjuje konvencionalni plućni monitoring. Određivanje idealnog alveolarnog rekrutmenta, koji održava otvorenim i funkcionalnim alveole tokom ventilacije, nosi minimalan rizik za leziju pluća prekomernim disajnim volumenom ('overdistension'), i smatra se ključnim za izvođenje koncepta protektivne ventilacije pluća ('lung protective ventilation'). U takvom kliničkom kontekstu, EIT se može koristiti kao dobar vodič za optimalno podešavanje parametara respiratorne podrške i načina ventilacije. Danas, sa tehničkim i tehnološkim razvojem, usavršavanjem hardvera i softvera EIT i eksperimentalnom validacijom rezultata na životinjama i na volonterima, omogućena je praktična klinička primena ove tehnologije u monitoringu regionalne plućne funkcije.

Ključne reči

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