Work

Pharmacologic Exhaustion of Suppressor Cells with Tasquinimod Enhances Bacterial Clearance during Tuberculosis

Year: 2018

Type: article

Abstract: the radiology department.This, arguably, limits the optimization of respiratory support during neonatal intensive care with existing monitoring tools focusing on ventilation alone.A further strength of this case report is the lack of any adjunctive respiratory support during the measurements.EIT demonstrated an almost complete lack of tidal ventilation in the left lung.EIT has been repeatedly shown to be able to differentiate single-lung ventilation in animal and human reports (5).Interestingly, EIT detected some residual tidal ventilation that clinicians would not have seen without the EIT recordings.The pulmonary artery infarct likely occurred after the pseudoglandular period and airway development.The residual ventilation likely represents bronchial tidal air movement and collateral ventilation via pores of Kohn.This suggests that EIT is able to image complex ventilation patterns within the lung at a resolution not currently possible within a bedside tool.EIT holds potential in monitoring ventilation and perfusion development in conditions characterized by unilateral lung differences and altered pulmonary blood flow, such as congenital diaphragmatic hernia and after cardiac surgery, over longer time periods.To date, the use of EIT to measure lung perfusion has been limited to human observations in which the perfusion state was not known (2) or animal models with selective occlusion of a single pulmonary artery and injection of an electrical impedance contrast agent (3).Our data support the preclinical data demonstrating the ability of EIT to selectively measure lung perfusion.The clear differentiation between the heartbeat-related signals within the left and right lung suggests that the cardiac-domain impedance measures within the anatomical regions of the chest containing lung are not exclusively due to heart movement being transmitted through lung regions.Conclusions.This case report describes the first report of EIT to measure perfusion and ventilation patterns in a newborn with a known loss of both in a single lung.EIT was able to demonstrate the perfusion and ventilation defects found on static radiological imaging.Importantly, EIT recordings within the heart-rate domain were independent of heart movement and at a respiratory resolution able to identify small areas of tidal ventilation.This suggests that EIT may hold promise as the first tool able to dynamically measure ventilation-perfusion matching over time in infants.

Source: American Journal of Respiratory and Critical Care Medicine

DOI: 10.1164/rccm.201805-0820le