Electrical impedance tomography in critical care: Advancing bedside respiratory monitoring and ventilation management

Electrical Impedance Tomography (EIT) is a transformative, non-invasive imaging tool in critical care, providing real-time, continuous monitoring of lung function. Originally applied to assess ventilation distribution in mechanically ventilated patients. EIT's scope has expanded significantly. It now encompasses a wide range of applications, including positive end-expiratory pressure (PEEP) titration, spontaneous breathing assessment, air trapping detection, alveolar recruitment guidance, and ventilation-perfusion (V/Q) matching. EIT supports personalized respiratory management across a range of therapies, including mechanical ventilation, high-flow nasal cannula (HFNC), and non-invasive ventilation (NIV), by identifying ventilation heterogeneity and preventing ventilator-induced lung injury (VILI). The ability of EIT to quantify regional lung mechanics, detect changes due to therapeutic interventions like suctioning and bronchodilation, and visualize complex phenomena such as pendelluft underscores its role in optimizing ventilation strategies and enhancing patient outcomes in critical care. Despite some technical challenges, EIT's integration into respiratory monitoring protocols is advancing, supporting data-driven, individualized management approaches that improve safety and outcomes for critically ill patients.