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All about the EIT technology and its effects on mechanical Ventilation.
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Monitor the respiratory cycle by applying small alternating currents
Unlike traditional imaging methods in medicine (e.g., computed-tomography or CT), Swisstom’s dynamic images are being reconstructed right at the bedside from raw data measured by a technology called Electrical Impedance Tomography (EIT): Weak alternating currents will be applied and travel along the paths of least resistance through the body, creating electric potentials at the body surface.
These potentials are being measured by an array of 32 electrodes within a sensor belt. The electrode arrangement is specifically designed to sequentially pick up signals coming from different directions. In this way the electrical “point of view” is constantly changing, creating moving images of local tissue resistances. This allows continuous visualization of lung and heart function – 24 hours a day, 7 days a week. Users are finally able to observe the lung during breathing – online, in real time and in color. The resulting images are completely transparent and provide an unmet amount of highly important information to the clinician right at the bedside.
The electrode vest: Pioneering in EIT perfection
One of the most important innovations by the Swisstom pioneers is the in-house developed concept of designing an active electrode that contains a microchip which will perform respective measurements. 32 of these microchips are being incorporated into a vest surrounding the patient’s thorax. Skin irritation is prevented due to the vest’s sophisticated design and use of skin-friendly fabrics.
During operation the sensor belt will be attached to a central sensor belt connector coordinating the individual electrodes. It will send all data measurements to a central processing unit that will continuously perform real time image reconstruction. Depending on your product, images will either be reconstructed and visualized by the Swisstom BBBB2 or reconstruced by a modular image creator box that will be plugged into a host device – either one of the common mechanical ventilators or vital signs monitors. The latter approach refers to our OEM division and results in visualization of the patient´s breathing on the screen of one of our OEM partners’ respirators or vital sign monitors.
Easy handling – unbeatable wearing comfort
Applying the vest to a patient is easy and can be accomplished within seconds. Handling of electronics is intuitive to doctors and other caregivers. Data paths to the monitor are short and dependable – requiring only one thin cable. The vest is available in different sizes and encompasses the human thorax almost like a second skin. The patient’s wearing comfort is hard to beat due to sophisticated fabric design and use of skin protective conductivity lotions.
Watch your patient’s lung during breathing
Electrical Impedance Tomography (EIT) by Swisstom displays your patient’s breathing lung directly on a monitor screen, making it visible for everyone. Similar to watching a movie, physicians and caregivers will finally see what’s going on within their patients’ chests. They will get an immediate feedback on their therapeutic measures right at the bedside – allowing fast and flexible action, reaction or correction. Our lung remains no longer a „black box“ – instead therapy and treatment can be adjusted to the constantly changing conditions during critical illness and applied more punctually. More patients will survive mechanical ventilation, be able to leave your ICU faster and with better health related quality of life.
Safer and more efficient hospital treatment
Electrical Impedance Tomography renders most time consuming control imagings by CT obsolete. Patients no longer need to be moved routinely to the department of radiologogy for control CTs, eliminating transport-associated risk and minimizing exposure to radiation. Work load on caregivers can be reduced and precious resources will be saved.
As a first step, Swisstom aims at implementing its sophisticated heart-lung monitor Swisstom BB2 within the critical care setting in order to to reduce the risk of Ventilator-associated lung injury (VALI) by providing previously unavailable information required for lung protective ventilation of the highest quality. As a second step, the basic principle of Swisstom’s EIT technology will also be implemented in devices designed for emergency medicine, operating rooms as well as medical practices and will complement functional diagnostics, monitoring of therapy or treatment success as well as endurance training in sports medicine.
EIT and the cardiovascular system
Very soon, EIT will be used to routinely monitor heart function by visualizing heart beat and determining contractility. Changes in blood volume due to major surgery or trauma will be monitored by EIT and assist in preventing levels of life saving fluid infusion too high or too low.
Changes in central blood pressure can be measured continuously, around the clock and non-invasively by EIT without annoying cuff inflations or invasive catheter placement. International statistics on mortality highlight the need for such measurements as every second death in the western world is caused by cardiovascular disease and mortality could decrease significantly.
EIT in the diagnosis of stroke
In patients with stroke, blood supply to sensitive tissues of particular brain regions will decline massively. Irreversible loss of functional brain tissue results depending on the duration of the lack of perfusion with the risk of irreversible damage increasing every minute. Pilot studies have shown that EIT is able to visualize pulsatile blood flow from outside of the skull. By using EIT, strokes might be detected faster, treated appropriately and reversed immediately onsite, thereby avoiding or attenuating irreversible compromises of health-related quality-of-life.
EIT in emergency medicine
Once outside of the hospital, emergency doctors have a very limited selection of tools for examining and diagnosing patients. EIT can be of quick help in evaluating whether both lungs are functioning normal or whether parts of the thorax are filled with free air or accumulated blood. As a reliable monitoring device, EIT provides a valuable tool to the emergency physician and the team awaiting the patient in the hospital. Thanks to the detailed information provided by the emergency team, the immediate follow treatment at the appropriate hospital will continue at the next level of care.
EIT for private practices
Cardiologists and pulmonologists will use EIT to assess their patient’s heart and lung function, supplementing conventional information obtained by X-ray, lung function testing and ultrasound. Depending on indication, telemetric EIT can be useful for monitoring pulmonary and cardiovascular function of patients at home or to collect long term data required for the optimization of a complicated therapy regimen.
EIT in sports medicine and endurance training
Future Swisstom products will support athletes and their coaches in detecting optimum training intensity. These products will be able to continuously record parameters of heart and lung function during activities like running, team sports, skiing, airborne activities, etc. Swisstom is currently developing advanced applications and products together with international top athletes.