Peeking into the black box of lung ventilation

September 2, 2011 by MassDevice

A new monitoring technology allows doctors to keep an eye on a child's lungs during ventilation without taking a picture.

EIT lung image

Can we monitor a child's lungs when they're on a ventilator without actually taking a picture? Yes, with a technology called EIT. (Courtesy Camille Gómez-Laberge)

By Tom Ulrich

Every year, thousands of children in intensive care units across the United States are put on mechanical ventilation to help them breathe. But while this technology has saved countless lives, it can also cause or worsen lung injury.

"A child's injured lungs don't often inflate uniformly under ventilation," says Gerhard Wolf, a critical care doctor in Children's Hospital Boston's Department of Anesthesia. "So one part of the lung may be nearly collapsed while another is overinflated. We need to be able to see that so we don't cause further damage."

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The problem is that the lung is something of a black box. There is no good way of directly telling whether a ventilator is inflating a child's lungs sufficiently. And while the use of continuous positive airway pressure systems during mechanical ventilation can in some cases help avoid damage, even there doctors would rather know exactly what is going on in the lung.


"We have learned very little about regional lung ventilation in the last 10 or 20 years," Wolf explains, "largely because of limitations in the technologies available for looking at the lungs of a child on a ventilator."