A Noninvasive Real-Time Monitoring System for Pulmonary Function Assessment

用于肺功能评估的无创实时监测系统

• 批准号: 8479262
• 负责人: Jeffrey M Ashe
• 金额: $ 86.52万
• 依托单位: GENERAL ELECTRIC GLOBAL RESEARCH CTR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8479262
• 关键词: 3-Dimensional; Acute; Address; Adopted; Adoption; Adult; Algorithms; Alveolar; Alveolus; Area; Atelectasis; Blood; Chest; Clinical; Clinical Data; Contrast Media; Data; Devices; Electrocardiogram; Electrodes; Environmental air flow; Evaluation; Failure; Feasibility Studies; Functional Residual Capacity; Goals; Government; Injection of therapeutic agent; Institutional Review Boards; Intensive Care; Intervention; Knowledge; Lung; Lung diseases; Maps; Measures; Mechanical ventilation; Methods; Metric; Monitor; Morphologic artifacts; Neonatal; Outcome; Patients; Performance; Perfusion; Persons; Positive-Pressure Respiration; Probability; Protocols documentation; Pulmonary Ventilation; Regional Perfusion; Replacement Therapy; Research; Respiratory physiology; Saline; Shunt Device; Solutions; System; Tidal Volume; Time; Titrations; Vascular blood supply; base; blood perfusion; electric impedance; human subject; improved; lung injury; lung volume; neonate; prevent; programs; pulmonary function; respiratory; response; surfactant; tomography; voltage; volunteer

DESCRIPTION (provided by applicant): Mechanical ventilation (MV) is the primary intervention used to assist neonatal and adult acute pulmonary failure patients, however, rapid and accurate assessment of patient function during ventilation remains an ongoing challenge. A primary cause of decreased lung efficiency in MV-assisted patients is ventilation/perfusion mismatch (V/Q mismatch): a mismatch between alveolar ventilation and pulmonary perfusion (blood supply). Intervention methods exist which can help to resolve V/Q mismatch, however effective application of these would benefit from a continuous monitoring method to guide successful therapy. In patients with pulmonary shunt, lack of ventilation at the alveoli, Positive End Expiratory Pressure (PEEP) is used with MV to maximize lung volume. If not monitored, lung damaging over-distention can occur. Surfactant replacement therapy can be used in neonates to resolve lung collapse (atelectasis) and patient maneuvering can be used to assist blood redistribution in patients with dead space - ventilation without perfusion. All of these methods would benefit from knowledge of what and how much therapy to administer, and to continuously monitor V/Q responses. No non-invasive continuous real-time clinical monitoring solution currently exists. We propose to develop a noninvasive, real-time, continuous Electrical Impedance Tomography (EIT) lung function monitoring system. EIT has been studied previously, however here we identify and address the technical limitations that have prevented clinical adoption. Upon successful completion, the clinician will have access to a device that will provide a 3-D regional ventilation/perfusion (V/Q) mismatch data, a 3-D regional indicator of atelectasis, and regional perfusion data.

描述（由申请人提供）：机械通气（MV）是用于帮助新生儿和成人急性肺衰竭患者的主要干预措施，然而，在通气期间快速准确地评估患者功能仍然是一个持续的挑战。 MV 辅助患者肺效率下降的主要原因是通气/灌注不匹配（V/Q 不匹配）：肺泡通气和肺灌注（血液供应）之间的不匹配。现有的干预方法可以帮助解决 V/Q 不匹配问题，但是这些方法的有效应用将受益于连续监测方法来指导成功的治疗。对于肺分流患者，肺泡通气不足，呼气末正压 (PEEP) 与 MV 结合使用以最大化肺容量。如果不进行监测，可能会发生损害肺部的过度膨胀。表面活性剂替代疗法可用于新生儿解决肺塌陷（肺不张）问题，患者机动可用于帮助死腔患者的血液重新分布 - 无灌注通气。所有这些方法都将受益于了解要进行什么治疗和多少治疗以及持续监测 V/Q 反应。目前尚不存在无创连续实时临床监测解决方案。 我们建议开发一种无创、实时、连续电阻抗断层扫描（EIT）肺功能监测系统。 EIT 之前已被研究过，但在这里我们确定并解决了阻碍临床采用的技术限制。成功完成后，临床医生将可以使用可提供 3D 区域通气/灌注 (V/Q) 不匹配数据、3D 区域肺不张指标和区域灌注数据的设备。