Background:

• ●

  Location:CMC Vellore Ranipet Hospital -ICU

• ●

  Date:06/03/2024

• ●

  Patient:67-year-old male

• ●

  Incident:Fallen from a height

• ●

  Injuries:L7&L8 ribs fracture、Lung contusion、Sacral injury、Right clavicle fracture

Ongoing Treatment

Non-Invasive Ventilation(NIV)

PEEP:7cmH20

PS:7cmH20

Fi02:21%

Date:06/03/2024

Images:

Image 1:NIV on G5 (Hamilton)

Changed to High Flow Nasal Cannula(HFNC)on ventilator

Flow:40 L/min

Fi02:21%

Date:06/03/2024

Images:

Image 2:HFNC on G5 (Hamilton)

On Spontaneous Breathing

Date:07/03/2024

Images:

Image 3:On Spontaneous Breathing

Clinical Decision

The decision was made to continue NIV without discharging the patient into the normal ward.

Discussion

The Spontaneous Breathing Trial(SBT)is the most commonly used method for weaning patients off mechanical ventilation.However,about 13%of patients who pass the SBT still fail to wean successfully and require reintubation.This suggests that SBT may have limitations in accurately assessing a patient's lung function due to its short duration.Electrical Impedance Tomography (EIT)offers a solution by providing quantitative indicators for a multidimensional assessment of lung function through real-time,dynamic monitoring of lung ventilation changes.

Infivision ET1000 was utilized to provide a real-time,dynamic assessment of the patient's lung ventilation,offering a more comprehensive evaluation of lung function.EIT can monitor regional lung ventilation changes and provide quantitative data,which is crucial in predicting weaning outcomes.

Conclusion

EIT has shown to be a valuable tool in the dynamic assessment of lung ventilation during the weaning process for mechanically ventilated patients.It aids in predicting weaning outcomes and offers a more accurate evaluation of lung function compared to the traditional SBT.This case supports the integration of Infivision ET1000 in clinical practice to improve the accuracy of weaning assessments and reduce the risk of reintubation.