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: 8164261
• 负责人: Alexander S Ross
• 金额: $ 83.23万
• 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/8164261
• 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. PUBLIC HEALTH RELEVANCE: Mechanical ventilation (MV) is a primary support mechanism for acute lung disease patients, both adult and neonatal. At present, there is no method for real-time noninvasive monitoring of lung recruitment and ventilation/perfusion mismatch (V/Q mismatch) at the bedside, making MV management a challenge. We propose to develop and validate a noninvasive, real-time lung function monitor that can guide therapy at the bedside, resulting in reduction of lung injury incidents and improved patient outcomes.

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，但是，通风期间对患者功能的快速评估仍然是一项持续的挑战。 MV辅助患者肺效率降低的主要原因是通风/灌注不匹配（v/q不匹配）：肺泡通气与肺部灌注之间的不匹配（血液供应）。存在干预方法可以帮助解决V/Q不匹配，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治疗。在肺管分流的患者中，肺泡缺乏通风，将阳性末期压力（PEEP）与MV一起使用，以最大程度地提高肺部体积。如果不监测，可能会发生肺部损害过度判断。表面活性剂替代疗法可在新生儿中使用以解决肺塌陷（胃张胸腔），并且可以使用患者操纵来帮助死亡空间的患者的血液再分配 - 通风而无需灌注。所有这些方法都将受益于了解要进行的治疗和数量的知识，并不断监视V/Q反应。目前不存在非侵入性连续实时临床监测解决方案。 我们建议开发一种无创，实时，连续的电阻抗层析成像（EIT）肺功能监测系统。 EIT先前已经进行了研究，但是在这里我们确定并解决了阻止临床采用的技术局限性。成功完成后，临床医生将可以使用3D区域通风/灌注（v/q）不匹配数据，肺不张症的3D区域指标和区域灌注数据。 公共卫生相关性：机械通气（MV）是成人和新生儿急性肺病患者的主要支持机制。目前，尚无对肺部的肺招募和通风/灌注不匹配（v/q不匹配）实时无创监测的方法，这使MV管理成为挑战。我们建议开发和验证无创，实时的肺功能监测仪，该监测器可以指导床边的治疗，从而减少肺部损伤事件并改善患者结果。