Effects of Patient Recumbency Position on Neonatal Chest EIT

Abstract

This paper investigates the overlooked effects of the patient recumbency positions on one of the key clinically used parameters in chest electrical impedance tomography (EIT) monitoring – the silent spaces. This parameter could impact medical decisions and interventions by indicating how well each lung is being ventilated. Yet it is largely dependent on assumptions of prior model at the reconstruction stage and the closely linked region of interest (ROI) during the final calculations. The potential effect of switching recumbency modes on silent spaces as a results of internal organ movements and consequently changes in initial assumptions, has been studied. The displacement and deformations caused by posture changes from supine to lateral recumbent were evaluated via simulations considering the simultaneous gravity-dependent movement and/or deformations of heart, mediastinum, lungs and the diaphragm. The reliability of simulations was verified against reference radiography images of an 18-month-old infant in supine and decubitus lateral positions. Inspecting a set of 10 patients from age range of 1 to 2 years old revealed improvements of up to 30% in the silent space parameters when applying posture consistent amendments as opposed to fixed model/ROI to each individual. To minimize the influence of image reconstruction technique on the results two different EIT reconstruction algorithms were implemented. The outcome emphasized the importance of including recumbency situation during chest EIT monitoring within the considered age range.

Keywords

• Electrical impedance tomography
• internal organ displacements
• lung deformation neonatal chest EIT
• recumbency position
• thorax modeling