Case Report


Use of the Electrical Impedance Segmentography system in a neonatal respiratory distress case

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1 Vicar Chief of NICU, Maternal and Child Health Department Policlinico G. Rodolico-Vittorio Emanuele Italy

2 Resident, Maternal and Child Health Department Policlinico G. Rodolico-Vittorio Emanuele Italy

3 Resident, Maternal and Child Health Department Policlinico G. Rodolico-Vittorio Emanuele Italy

4 Resident, Maternal and Child Health Department Policlinico G. Rodolico-Vittorio Emanuele Italy

5 Resident, Maternal and Child Health Department Policlinico G. Rodolico-Vittorio Emanuele Italy

6 Pediatric Cardiologist, Maternal and Child Health Department Policlinico G. Rodolico-Vittorio Emanuele Italy

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Pasqua Maria Betta

Vicar Chief of NICU, Maternal and Child Health Department, Policlinico G.Rodolico-Vittorio Emanuele,

Italy

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Article ID: 100961Z01PB2018

doi: 10.5348/100961Z01PB2018CR

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How to cite this article

Betta PM, Fatuzzo V, Lanzafame A, Castro A, Giallongo A, Pietro S. Use of the Electrical Impedance Segmentography system in a neonatal respiratory distress case. Int J Case Rep Images 2018;9:100961Z01PB2018.

ABSTRACT


Introduction: The Electrical Impedance Segmentography system (EIS) is a technique able to detect any kind of dishomogeneities between the pulmonary segments and to study the air distribution and the regional current volumes, by monitoring the impedance in the four pulmonary quadrants, in a continuous, non-invasive, fast and low-cost manner. We used this method for the management of a patient born at term with respiratory distress.

Case Report: On admission to the ward, a noninvasive respiratory assistance was set up. The chest X-ray showed a massive opacity of the left hemithorax as due to a pulmonary atelectasis. Therefore, we decided to administer surfactant by the ET tube using the INSURE technique, with a slight, clinical and radiological improvement. At the same time, we started to monitor our patient ventilation using the EIS: in agreement with the radiological findings, it revealed an initial exclusion of the left, lower, pulmonary lobe and a progressive lung recruitment. It also showed immediate changes of the EIS patterns after every therapeutic maneuver (airway aspiration, surfactant administration, PEEP variations). On the 10th day of life a clinical stabilization and a complete radiological resolution were achieved, so the baby was weaned from the respiratory assistance.

Conclusion: The presented case, in agreement with the literature, shows that the EIS can represent a safe and effective guide to set up the mechanical ventilation in newborns. In fact, it supplies a non-invasive and immediate assessment of ventilation, highlighting the poor ventilated areas and allowing immediate therapeutic adjustments.

Keywords: Electrical impedance segmentography, Monitoring, Respiratory distress syndrome, Surfactant

SUPPORTING INFORMATION


Author Contributions:

Pasqua Maria Betta - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Valentina Fatuzzo - Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published

Angela Lanzafame - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Agnese Castro - Analysis of data, Interpretation of data, Final approval of the version to be published

Alessandro Giallongo - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Sciacca Pietro - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source Of Support

None

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2018 Pasqua Maria Betta et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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