ArticleFrontiers in medicine2026
Dynamic changes in regional ventilation distribution and end-expiratory lung impedance using electrical impedance tomography: associations with weaning and extubation outcomes.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Accurately assessing the optimal timing for extubation remains a significant challenge in intensive care units (ICUs). The rapid shallow breathing index (RSBI) is widely used but lacks insight into regional lung physiology. This study aimed to characterize dynamic changes in regional ventilation distribution and end-expiratory lung impedance (EELI) using electrical impedance tomography (EIT) during spontaneous breathing trials (SBTs) and to explore their association with weaning and extubation outcomes. Methods: In this prospective observational study, 52 mechanically ventilated patients undergoing their first SBT were enrolled. EIT parameters, including the Global Inhomogeneity (GI) index, center of ventilation (COV), ventrodorsal ventilation asymmetry (|ROI V-D|), and changes in EELI (ΔEELI), were recorded at four time points. Weaning failure was defined as SBT failure, or as reintubation or noninvasive ventilation within 48 h after extubation. Extubation failure was defined as reintubation or rescue NIV within 48 h. Logistic models coded 1 = failure and 0 = success. Results: SBT failure ( Conclusions: EIT-derived parameters offer insights into regional ventilation changes during the weaning process. Increased ventilation inhomogeneity and ventrodorsal mismatch are associated with SBT failure, while loss of end-expiratory lung impedance is associated with extubation failure. Adding EIT parameters to RSBI provided exploratory incremental information for discriminating SBT failure and extubation failure in this cohort. These secondary analyses require external validation before any clinical application can be considered.
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