Monitoring of Regional Ventilation Distribution Using Electrical Impedance Tomography in Pediatric Patients With Chest Physiotherapy-A Feasibility Study.

backgroundCurrent evidence remains unclear whether pediatric patients with acute or chronic lung diseases benefit from chest physiotherapy (CPT) during spontaneous breathing. Electrical impedance tomography (EIT) offers the opportunity to assess treatment effects of CPT on regional ventilation distribution.

methodsWe conducted a prospective feasibility study between 10/2023 and 05/2024. Pediatric patients with need for active or passive CPT were screened. EIT measurements were performed immediately before CPT intervention (T1), and within 30 min after CPT intervention (T2).

resultsOverall, 25 patients were enrolled, with two patients enrolled twice at different admissions, resulting in a total of 54 EIT-measurements. The mean horizontal center of ventilation (CoVx) and the mean vertical CoVy were equally distributed at T1 and T2, without any difference seen when subdividing for mode of CPT. The mean global inhomogeneity index (GI) decreased from 0.38 to 0.36 (∆GI: -6%, p = 0.939) in the overall cohort, with a significant decrease between T1 and T2 in patients with active (∆GI: -10%, p = 0.015), but not in patients with passive CPT (∆GI: +6%, p = 0.199). In patients with a localized pulmonary finding in the radiological assessment (n = 10) we observed an increase in the ventilated lung area (EIT-pixel) of the affected lung side after CPT (T1: 141 vs. T2: 176; p = 0.128).

conclusionEIT seems feasible to monitor changes in regional ventilation distribution after CPT in pediatric patients. Patients with localized pulmonary radiological findings and patients after active CPT appear to benefit most from CPT, whereas there is a subset of individuals with no response to CPT.