445 - Use of the EIS (Electrical Impedence Segmentography System) in less-invasive surfactant administration (LISA) in newborns suffering from Neonatal Distress Syndrome.

Poster Number: 445
Publication Number: 445.227

Monica Tosto, Maternal Infant Department, AOU Policlinico G. Rodolico-San Marco, University of Catania, TREMESTIERI ETNEO, Sicilia, Italy; Carmine Loretta Mattia, Children's Hospital, Catania, Sicilia, Italy; Pietro Sciacca, Maternal Infant Department of AZienda ospedaliera Universitaria Policlinico Rodolico San Marco - Università di Catania, Catania, Sicilia, Italy; Pasqua Betta, Maternal Infant Department, AOU Policlinico G. Rodolico-San Marco, University of Catania, Catania, Sicilia, Italy

Background: Electrical Impedance Segmentography (EIS) is a valid system for continuous monitoring of lung volumes and ventilation distribution of new-borns admitted to intensive care units. Simple, non-invasive, free of radiation, it is a complementary technique to the most common methods used in the context of respiratory problems in the new-born. It allows extemporaneous feedback on many therapeutic measures and guarantees a more careful management.

Objective: The goal of our study was to analyze the parameters deriving from EIS monitoring in infants suffering from respiratory distress syndrome and treated with surfactant using the LISA technique. Our aim is to demonstrate how the real-time results provided by the EIS can compensate for the use of chest X-rays, accelerating the identification of any type of complication and allowing immediate therapeutic adjustments, improving the quality of care.

Design/Methods: We enrolled 9 infants (gestational age between 31 and 38 W, weighing between 1460g and 3600g) suffering from respiratory distress, occurred within 6 hours of life. All patients studied underwent EIS that monitors the impedance across four quadrants of the lung through surface electrodes on the chest in the upper and lower region on the left and right and in the sternal area. The duration of the examination was set at a minimum of 40 minutes from the administration of the surfactant. In all patients we noted the amount of pre- or post-surfactant FiO2, the pre and post surfactant SaO2, the number of surfactant doses, the type and duration of ventilation, heart and respiratory rate.

Results: All infants received only one dose of surfactant at 200 mg/kg, and there was a rapid improvement in SaO2 and a reduction of FiO2 levels and of duration of non-invasive ventilation. Before the surfactant, a group I, consisting of 66% of the new-borns, had only a partially ventilated lobe, a group II, consisting of 22% of the patients, it ventilated only 2 lobes and a third group, given by 12% of cases, did not ventilate any lung lobe. After surfactant administration, in the first group 33% had a complete opening of 3 lung lobes, 50% had an opening of all 4 lung lobes and 17% of only one lung lobe. As regards the II group, complete ventilation of only 2 lung lobes was obtained in all, while in the III group only one lung lobe ventilation was obtained.Conclusion(s): The EIS allows to detect volume changes in many therapeutic measures: changing the ventilation mode, correct positioning of the endotracheal tube, recruitment manoeuvres, lung aspiration, pneumothorax drainage, the administration of surfactant and so on.