Table 1_Case report: Electrical impedance tomography-guided ventilator weaning in an obese patient with severe pneumonia.docx

BackgroundElectrical impedance tomography (EIT) evaluates lung function by providing continuous, real-time monitoring of regional lung ventilation distribution to guide the restoration of lung ventilation. Patients with obesity who are dependent on mechanical ventilation often struggle with weaning. This case report highlights the potential of EIT to guide the weaning of ventilator-dependent patients in an obese patient with severe pneumonia.
Case summaryA 23-year-old male obese patient was admitted to Zhongshan People’s Hospital in November 2023 due to progressive dyspnea. He suffered from recurrent fever and worsening oxygenation and had a 20+ year history of syringomyelia. Combined with abnormal computed tomography imaging, the discovery of a viral infection in the bronchoalveolar lavage fluid, and next-generation sequencing results, he was diagnosed with severe pneumonia. In addition to conventional treatment, EIT was used to guide him through postural changes and ventilation recovery. EIT-informed prone positioning improved ventilation distribution and facilitated successful ventilator weaning on day 26. The patient was discharged after recovering spontaneous respiratory function.
ConclusionEIT may help ventilator-dependent obese patients achieve tailored targets to improve ventilatory outcomes.

背景：
电阻抗断层成像（Electrical impedance tomography, EIT）通过对肺部区域通气分布进行连续实时监测以评估肺功能，并指导肺通气功能恢复。依赖有创机械通气的肥胖患者常难以成功脱机。本病例报告阐明了EIT在重症肺炎肥胖呼吸机依赖患者脱机过程中的应用潜力。
病例摘要：
2023年11月，一名23岁男性肥胖患者因进行性呼吸困难就诊于中山市人民医院。患者存在反复发热、氧合状况恶化病史，且有长达20余年的脊髓空洞症病史。结合患者异常的计算机断层扫描（computed tomography, CT）影像结果、支气管肺泡灌洗液病毒检测阳性结果及二代测序（next-generation sequencing, NGS）报告，最终确诊为重症肺炎。除常规治疗外，临床采用EIT指导患者进行体位调整与通气功能恢复。基于EIT指导的俯卧位通气改善了患者的肺部通气分布，使其在住院第26天成功实现呼吸机脱机。患者自主呼吸功能恢复后顺利出院。
结论：
EIT可帮助呼吸机依赖的肥胖患者达成个体化通气目标，从而改善通气预后。