Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside
Abstract Background In congenital heart disease (CHD), the evaluation of pulmonary perfusion remains challenging, particularly in pediatric critically ill patients, where anatomical anomalies significantly impact pulmonary blood flow. We aim at demonstrating the reliability and the accuracy to inves...
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SpringerOpen
2025-07-01
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| Series: | Intensive Care Medicine Experimental |
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| Online Access: | https://doi.org/10.1186/s40635-025-00783-3 |
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| author | Alfio Bronco Francesco Fazzi Liliana Amendolagine Roberta Garberi Stefano Cattaneo Floriana Ferrari Ezio Bonanomi Giuseppe Foti Emanuele Rezoagli |
| author_facet | Alfio Bronco Francesco Fazzi Liliana Amendolagine Roberta Garberi Stefano Cattaneo Floriana Ferrari Ezio Bonanomi Giuseppe Foti Emanuele Rezoagli |
| author_sort | Alfio Bronco |
| collection | DOAJ |
| description | Abstract Background In congenital heart disease (CHD), the evaluation of pulmonary perfusion remains challenging, particularly in pediatric critically ill patients, where anatomical anomalies significantly impact pulmonary blood flow. We aim at demonstrating the reliability and the accuracy to investigate pulmonary perfusion in the presence of CHD by using electrical impedance tomography (EIT), a non-invasive, bedside, real-time, radiation-free imaging technique that assesses lung ventilation and perfusion. Results This methodologies series explores the application of EIT in three pediatric critically ill patients with CHD admitted to the Pediatric Intensive Care Unit at Papa Giovanni XXIII Hospital, Bergamo, Italy: (1) a newborn post-corrective surgery for transposition of the great arteries; (2) an infant post-repair of tetralogy of Fallot with bilateral pulmonary branch stenosis; and (3) an infant with severe hypoxemia following Stage I Norwood–Sano repair. EIT perfusion was performed by injecting a bolus of 0.5 ml/kg of 5% saline through a central venous catheter during an inspiratory hold and was compared to standard imaging techniques that assess pulmonary perfusion. EIT findings were consistent with conventional imaging modalities that are not available at bedside (i.e., computed tomography, magnetic resonance imaging, angiography) or that do not allow regional assessment of lung perfusion and are operator dependent (i.e., ultrasound), demonstrating the reliability and the accuracy of EIT assessment. EIT provided critical insights into ventilation–perfusion dynamics, allowing to identify perfusion defects and guiding clinical decisions. Conclusions This clinical investigation highlights the potential of EIT to improve pulmonary perfusion monitoring and clinical management of complex CHD cases in pediatric critically ill patients. Further research is needed to establish standardized protocols and validate the EIT clinical utility in larger cohorts. |
| format | Article |
| id | doaj-art-a7e62b5e2f064f57aaeb3961b0823b97 |
| institution | Kabale University |
| issn | 2197-425X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj-art-a7e62b5e2f064f57aaeb3961b0823b972025-08-20T03:45:43ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2025-07-011311710.1186/s40635-025-00783-3Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedsideAlfio Bronco0Francesco Fazzi1Liliana Amendolagine2Roberta Garberi3Stefano Cattaneo4Floriana Ferrari5Ezio Bonanomi6Giuseppe Foti7Emanuele Rezoagli8Pediatric Anesthesiology and Intensive Care Unit, ASST Papa Giovanni XXIII, HPG23 HospitalPediatric Anesthesiology and Intensive Care Unit, ASST Papa Giovanni XXIII, HPG23 HospitalSchool of Medicine and Surgery, University of Milano-BicoccaSchool of Medicine and Surgery, University of Milano-BicoccaPediatric Anesthesiology and Intensive Care Unit, ASST Papa Giovanni XXIII, HPG23 HospitalPediatric Anesthesiology and Intensive Care Unit, ASST Papa Giovanni XXIII, HPG23 HospitalPediatric Anesthesiology and Intensive Care Unit, ASST Papa Giovanni XXIII, HPG23 HospitalSchool of Medicine and Surgery, University of Milano-BicoccaSchool of Medicine and Surgery, University of Milano-BicoccaAbstract Background In congenital heart disease (CHD), the evaluation of pulmonary perfusion remains challenging, particularly in pediatric critically ill patients, where anatomical anomalies significantly impact pulmonary blood flow. We aim at demonstrating the reliability and the accuracy to investigate pulmonary perfusion in the presence of CHD by using electrical impedance tomography (EIT), a non-invasive, bedside, real-time, radiation-free imaging technique that assesses lung ventilation and perfusion. Results This methodologies series explores the application of EIT in three pediatric critically ill patients with CHD admitted to the Pediatric Intensive Care Unit at Papa Giovanni XXIII Hospital, Bergamo, Italy: (1) a newborn post-corrective surgery for transposition of the great arteries; (2) an infant post-repair of tetralogy of Fallot with bilateral pulmonary branch stenosis; and (3) an infant with severe hypoxemia following Stage I Norwood–Sano repair. EIT perfusion was performed by injecting a bolus of 0.5 ml/kg of 5% saline through a central venous catheter during an inspiratory hold and was compared to standard imaging techniques that assess pulmonary perfusion. EIT findings were consistent with conventional imaging modalities that are not available at bedside (i.e., computed tomography, magnetic resonance imaging, angiography) or that do not allow regional assessment of lung perfusion and are operator dependent (i.e., ultrasound), demonstrating the reliability and the accuracy of EIT assessment. EIT provided critical insights into ventilation–perfusion dynamics, allowing to identify perfusion defects and guiding clinical decisions. Conclusions This clinical investigation highlights the potential of EIT to improve pulmonary perfusion monitoring and clinical management of complex CHD cases in pediatric critically ill patients. Further research is needed to establish standardized protocols and validate the EIT clinical utility in larger cohorts.https://doi.org/10.1186/s40635-025-00783-3Lung perfusionCongenital heart diseaseElectrical impedance tomographyVentilationCardiopulmonary interaction |
| spellingShingle | Alfio Bronco Francesco Fazzi Liliana Amendolagine Roberta Garberi Stefano Cattaneo Floriana Ferrari Ezio Bonanomi Giuseppe Foti Emanuele Rezoagli Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside Intensive Care Medicine Experimental Lung perfusion Congenital heart disease Electrical impedance tomography Ventilation Cardiopulmonary interaction |
| title | Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside |
| title_full | Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside |
| title_fullStr | Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside |
| title_full_unstemmed | Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside |
| title_short | Electrical impedance tomography in congenital heart disease: advancing non-invasive pulmonary perfusion assessment at bedside |
| title_sort | electrical impedance tomography in congenital heart disease advancing non invasive pulmonary perfusion assessment at bedside |
| topic | Lung perfusion Congenital heart disease Electrical impedance tomography Ventilation Cardiopulmonary interaction |
| url | https://doi.org/10.1186/s40635-025-00783-3 |
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