Application of internal electrodes to the oesophageal and tracheal tube in an animal trial: evaluation of its clinical and technical potentiality in electrical impedance tomography.

Electrical impedance tomography (EIT) is of potential medical interest e.g., to optimize ventilator settings during mechanical ventilation. Nevertheless there are still several challenges. Although electrode belts are commonly used and promoted, they are not necessarily adequate for the long-term monitoring of patients in intensive-care units (ICU). ICU patients are usually equipped with breathing tubes and feeding tubes, ideal surfaces to attach EIT electrodes to. The aim of our study was therefore to examine the potentiality of internal electrodes in a porcine animal trial. Following an animal trial protocol studying acute lung injury, additional EIT measurements were obtained both with conventional electrodes set upon a rubber belt and after having moved the electrodes internally in seven pigs. For this reason the two most dorsally located electrodes were selected. An adjacent stimulation and measurement pattern was used, and resulting voltages in the time and frequency domains as well as within reconstructed images were examined to compare perfusion and ventilation data qualitatively and quantitatively. Particularly, lung morphology as well as signal strength for both the mediastinal and lung region were studied. All animals were submitted to the additional protocol without any adverse events. Distinguishability of lungs was improved in reconstructed frames. The resulting sensitivity of measured electrical impedance was enhanced around the mediastinal region and even cardiac-related activity was significantly increased by a factor of up to 6. In conclusion the application of internal electrodes appears to be beneficial for diverse clinical purposes and should be addressed in further studies.