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Novel technologies to detect atelectotrauma in the injured lung

ABSTRACT Cyclical recruitment and derecruitment of lung parenchyma (R/D) remains a serious problem in ALI/ARDS patients, defined as atelectotrauma. Detection of cyclical R/D to titrate the optimal respiratory settings is of high clinical importance. Image-based technologies that are capable of detecting changes of lung ventilation within a respiratory cycle include dynamic computed tomography (dCT), synchrotron radiation computed tomography (SRCT), and electrical impedance tomography (EIT). Time-dependent intra-arterial oxygen tension monitoring represents an alternative approach to detect cyclical R/D, as cyclical R/D can result in oscillations of PaO2 within a respiratory cycle. Continuous, ultrafast, on-line in vivo measurement of PaO2 can be provided by an indwelling PaO2 probe. In addition, monitoring of fast changes in SaO2 by pulse oximetry technology at the bedside could also be used to detect those fast changes in oxygenation.