电阻抗断层成像在急性呼吸窘迫综合征精准治疗中的应用

Application of electrical impedance tomography in the precision treatment of acute respiratory distress syndrome

摘要

肺电阻抗断层成像（EIT）作为床旁、无创、可连续监测的功能成像技术，能够实时可视化区域通气分布及其动态变化，并在体位管理、肺复张与塌陷监测、呼气末正压（PEEP）滴定与肺保护性通气优化等方面提供决策支持。文章重点综述了 EIT 在急性呼吸窘迫综合征（ARDS）通气监测、个体化通气策略制定、俯卧位反应评估、撤机/自主呼吸试验风险评估、通气/血流匹配（V/Q）评估及特定病因与亚表型管理中的应用进展，并与 CT、肺超声等技术进行了对比，总结了 EIT 技术在 ARDS 精准治疗领域的最新研究进展，可为临床医生应用该技术实施 ARDS 个体化治疗提供重要参考。

Abstract

Electrical impedance tomography (EIT) was recognized as a bedside, non-invasive, and continuous functional imaging technique, and enables real-time visualization of regional ventilation distribution and its dynamic changes. It provides decision support in areas such as positioning management, monitoring of lung recruitment and collapse, PEEP titration, and optimization of lung-protective ventilation. This review summarizes the research progress of EIT in acute respiratory distress syndrome (ARDS), focusing on its applications in ventilation monitoring, formulation of individualized ventilation strategies, evaluation of prone position response, risk assessment for weaning/spontaneous breathing trials, evaluation of ventilation/perfusion (V/Q) matching, and management of specific etiologies and subphenotypes. Comparisons between EIT and other modalities, such as CT and lung ultrasound, were also discussed. In conclusion, the latest advancements in EIT technology for the precision treatment of ARDS were summarized and served as a valuable reference for clinicians to implement individualized care for patients with ARDS.

关键词

电阻抗断层成像 / 急性呼吸窘迫综合征 / 精准治疗 / 个体化机械通气 / PEEP 滴定 / 肺复张 / 俯卧位 / 通气/血流匹配

Key words

Electrical Impedance Tomography / Acute Respiratory Distress Syndrome / Precision Treatment / Individualized Mechanical Ventilation / PEEP Titration / Lung Recruitment / Prone Position / Ventilation/Perfusion (V/Q) Matching

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基金资助

广东省基础与应用基础研究基金省企联合基金(面上项目)(2024A1515220118)

新发突发与重大传染病防控国家科技重大专项(2025ZD01902600)

国家自然科学基金(82572456)

国家自然科学基金(82272189)